Private pay psychiatry in San Francisco: what you get and whether it’s worth it
Thinking about paying out of pocket for psychiatric care? Here’s how private pay works, what it costs and who it’s a good fit for.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
✓ Medically reviewed by Earl Johns, MSN, PMHNP-BC
More people in San Francisco are choosing private pay, also called self-pay or cash pay, for psychiatric care. Sometimes it’s because their insurance has long waitlists or few affirming providers. Sometimes it’s about privacy, time or flexibility. Here’s what to know before you decide.
What private pay psychiatry usually offers
Longer, unhurried visits instead of rushed 15-minute med checks.
More flexibility in scheduling, including evenings and weekends at some practices.
Care that isn’t limited by what an insurer will authorize.
More privacy, since no claim or diagnosis is sent to your insurance unless you choose to submit one.
The ability to choose a provider who truly fits, such as an LGBTQ+ or neurodivergent-affirming clinician.
What it costs
Private pay psychiatry in the Bay Area typically costs more per visit than an insurance copay, and fees vary by provider and visit length. An initial psychiatric evaluation is usually the longest and most expensive visit, followed by shorter follow-ups. Many people use HSA or FSA funds, and some get partial reimbursement through out-of-network benefits.
Who private pay is a good fit for
Private pay often works well for professionals who value privacy and scheduling flexibility, people whose insurance doesn’t include an affirming provider they trust, and anyone who wants more time and a whole-person approach. If cost is a concern, using in-network insurance is a great option too. Wellthy Psychiatry accepts several insurance plans as well as private pay.
Current self-pay rates, testing costs and policies are listed on our fees and policies page. Self-pay clients receive a Good Faith Estimate when scheduling.
Care in San Francisco and across California
Wellthy Psychiatry is an LGBTQ-owned practice led by Earl Johns, MSN, PMHNP-BC, a board-certified psychiatric nurse practitioner offering medication management and therapy in San Francisco and by telehealth across California. If you’re looking for a gay or LGBTQ+ therapist in San Francisco, LGBTQ+-affirming psychiatric care in San Francisco, or affirming therapy anywhere in California, we’d love to help. Book a free 15-minute consult.
About the author
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner · UCSF-trained · Founder of Wellthy Psychiatry & Wellness
Earl provides LGBTQ+ and neurodivergent-affirming psychiatric care, blending medication management, therapy and whole-person approaches. He sees clients in San Francisco and by telehealth across California.
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