Average Er Copay



Below is helpful information regarding what to expect when paying for behavioral health care services.

Paying for Outpatient Treatment

Average Copay For Er Visit

If you have insurance

Average Er CopayAverage Er Copay
  • Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP):
    • Many programs bill you when you finish the program; if you can’t pay all at once you can ask about payment plan options before starting treatment
    • Your insurance plan may cover these treatments; the staff will talk to you about your coverage before you start treatment
  • Psychiatrists and therapists:
    • Expect to pay your co-pay at each appointment
    • If your insurance is not accepted you may still get reimbursed from your insurance company if you have Out-of-Network Reimbursement Benefits; call the customer service number on your insurance card to find out if your insurance company will pay you back
    • If your employer offers an Employee Assistance Program (EAP) you may be able to get a certain number of free sessions with a therapist
    • If you have questions or concerns about payment, you should discuss them with your therapist or psychiatrist
  • Average co-pay costs for outpatient treatment:
    • PHP: approximately $25 – $100 a day
    • IOP: approximately $25 – $80 a day
    • Psychiatrists: approximately $15 – 60 per session
    • Therapists: approximately $10 – $60 per session
    • Support groups: most are free

The copay for Medi-Share (called a provider payment or provider fee) is $35 for a doctor/hospital visit and $200 for an emergency room visit. Traditional insurance plans used to have lower copays but now tend to average a similar amount. The average urgent care visits range from $100 to $150, depending on the patient’s co-pay and level of treatment, according to Dr. Franz Ritucci, President of the American Academy of Urgent Care Medicine. Ritucci said that 70% of patients at urgent care centers use health insurance and their only cost is a co-pay. Average MRI $500–$1,300 Average CAT scan $400–$700 Maternity Services Typical Cost Estimate Pregnancy (includes prenatal and delivery costs) Vaginal delivery without complications $9,800–$11,000 C-section delivery without complications $11,500–$12,700 ® Registered Marks of the Blue Cross and Blue Shield Association.

If you are uninsured

  • Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP):
    • Many programs bill you when you finish the program; if you can’t pay all at once you can ask about payment plan options before starting treatment
    • Ask if the program offers financial assistance
    • Remember to inquire about payment options BEFORE starting treatment
    • The average daily cost can range from $300 – 400 per day without insurance
  • Psychiatrists:
    • Initial evaluations usually cost between $250 – $350 and follow-ups are $100 to $200 for 30- to 60-minute sessions
    • Payment is expected at each appointment
    • Remember to inquire about payment options BEFORE starting treatment
  • Therapists:
    • Some therapists offer sessions at a lower rate called “sliding scale fees”; ask about this when you schedule an appointment
    • In bigger cities there are often non-profit agencies that offer counseling services for the uninsured or underinsured
    • For referrals in Central Texas, contact 211 or a Ascension Seton Behavioral Health Navigator at 512-324-2039
  • Uninsured financial help:
    • If you are uninsured and cannot pay the full fee to see a psychiatrist or therapist, most communities have state or city funded agencies or Community Mental Health Centers (CMHC) that may be able to help
    • To find a CMHC, call 211 or search online
    • In some cities, you can find non-profit agencies that offer counseling services
    • Be aware that you may have to go through a screening process and these agencies may have waiting lists
    • These clinics often take Medicare, Medicaid, MAP (Travis County) and marketplace insurance plans
    • For referrals or more information about services in Central Texas, contact 211 or a Ascension Seton Behavioral Health Navigator at 512-324-2039

How Much Is An Er Copay

Paying for Inpatient Treatment

  1. Average co-pay: Psychiatric Emergency Room: approximately $100 per visit Acute hospitalization, including detox: approximately $175 – $750 per day (some insurance companies may pay a percentage of the co-pay after you have reached your out of pocket maximum; some may also limit the number of days they will pay for in a year, ranging from five.
  2. A copay is a set amount you pay for a service. A coinsurance is a percentage of the full cost of a service. Those payments and your deductible payments count toward your out-of-pocket maximum. 1 Your out-of-pocket maximum helps protect you financially if you get sick or injured.
Average Er Copay

If you have insurance

Average Er Copay
  • Acute inpatient treatment is often covered or partially covered by insurance, including Medicare; you have the right to know what will be covered and what you will have to pay
  • The hospital or facility will help check your insurance coverage before you are admitted; this is a good time to ask about payment plans
  • Many insurance companies require “pre-certification,” which means that the hospital staff will give your insurance company information about why you need treatment to make sure your hospital stay will be covered
  • Contact customer service at your insurance company to seek answers to the following important treatment questions:
    • What facilities are in-network? What facilities are out-of-network? What is the difference in cost?
    • Are there limits on how long I can be in the hospital or in residential treatment? Are there limits on how often I can be in the hospital or in residential treatment?
    • Am I required to use a facility that is “accredited?” (Accreditation means the treatment facility meets the standards of the accrediting group; you can check to see if the facility is accredited at
      findtreatment.samhsa.gov/locator/home.)
  • Average co-pay:
    • Psychiatric Emergency Room: approximately $100 per visit
    • Acute hospitalization, including detox: approximately $175 – $750 per day (some insurance companies may pay a percentage of the co-pay after you have reached your out of pocket maximum; some may also limit the number of days they will pay for in a year, ranging from five to 30 days)
    • Residential treatment: approximately $175 – $750 per day

What Is Included In Er Copay

If you are uninsured

Average Er Copay Cost

  • Many communities in Texas have options for financial support or community-based detox programs; in Central Texas OSAR (Outreach, Screening, Assessment and Referral) can be reached by calling 1-877-9-NO-DRUG
  • Some psychiatric hospitals and residential facilities will offer options for financial assistance for the needed treatment
  • Most hospitals or facilities will also have an option for private pay, meaning that you do not have to have or use insurance to cover the costs




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