Finding an insurer that pays therapists a rate in line with their level of education and specialization can be nearly impossible, and time spent filling out the

Finding an insurer that pays therapists a rate in line with their level of education and specialization can be nearly impossible, and time spent filling out the billing paperwork (often only to be rejected for payment or even "clawed back" after the fact) isn't billable. Many folks I know that have private clinical practices address the tension between this and ensuring that there's access for people that can't afford the full rate out of pocket by charging a really high rate for most patients and then doing sliding scale/pro bono work.