The numbers, before you have to ask for them.
You shouldn’t have to book a call with someone to find out what they charge. So here it is — what a session costs, why I don’t go through insurance, and what the money actually buys you.
Two lengths. Both per couple.
Eighty minutes
$280
80-minute session
Start here if you can. Fifty minutes has a habit of running out precisely when something real has surfaced. Eighty leaves enough room to open a pattern, work on it, and put it down somewhere sensible — instead of stopping mid-thought and picking it up a week later.
Fifty minutes
$175
50-minute session
A real option, not a lesser one, and the right call when the longer session won’t fit the week or the budget. A good number of couples do their entire course of work at this length.
Both figures include New Mexico gross receipts tax. The number on this page is the number you pay — nothing gets added at the end. And the fee is for the appointment, not for each of you. You come as a couple, it’s one session, it’s one charge.
How it works in practice.
I email you an invoice, and it’s settled before we meet — so the whole session goes on the work rather than on admin at either end. Any card works, debit or credit, and HSA cards are accepted too.
You’re also entitled to a good faith estimate of what your care will cost, and I’m glad to write one whenever you’d like it. I’ll be honest that it’s an estimate in the real sense: I don’t set a required number of sessions, and I can’t know in advance how many you’ll want in order to get where you’re going.
I don’t bill insurance, and the reason isn’t convenience.
It’s that doing it their way would require me to write something untrue into one of your medical records.
Insurance pays for treating diagnosed mental illness. For your plan to cover our work, I would have to nominate one of you as the patient, attach a psychiatric diagnosis to that person, and state that the sessions are treating their disorder.
That isn’t what we’d be doing. Neither of you is ill. What you have is a problem between you — and a problem between two people doesn’t clear the bar insurers call medical necessity. Recording it as though it did is fraud, and it would park a psychiatric diagnosis in one of your permanent records for no clinical reason whatsoever.
There’s a second thing worth knowing. Under that arrangement only the diagnosed person is legally the client. They get confidentiality, a duty of care, access to the notes. The other one of you is present as support — technically collateral to someone else’s treatment, with none of those protections.
Some therapists bill this way regardless. I’m telling you all this so you understand my answer, and so you understand what someone else’s yes actually involves.
What I will do: give you a receipt or superbill on request. It carries Z63.0, relational distress, and it names both of you as the clients — because that is what’s true. Expect your plan to turn it down. Z63.0 isn’t a mental illness code, so most insurers won’t pay against it, which is rather the point. The only route to reimbursement would be swapping it for a psychiatric diagnosis neither of you has, and I won’t do that. Please don’t budget around getting that money back.
It’s a real amount. Here’s what sits behind it.
More than fifteen years focused on couples
This isn’t a general practice with couples work bolted on the side. Fifteen years and more have gone into two people and what happens between them — which is why I can usually name the pattern you’re caught in during the first session, rather than the fifth.
Certification that took something
AASECT certification meant over 160 hours of specialised coursework, 50 hours of supervision, and hundreds of clinical hours with couples.
Worth knowing what that’s worth: exactly one state in the country regulates the term “sex therapist” — Florida. Everywhere else, New Mexico included, anyone at all may put it on a website. The certification is the only thing that distinguishes one claim from another, and it’s not something you can acquire over a weekend.
Work that finishes
Three to six months is typical. I’m not trying to become a permanent fixture in your calendar — the entire point is that you get to stop coming.
Everything else you might want to check.
What happens if we cancel?
I need 48 hours’ notice. Inside that window the session is charged in full, because the time was held for you and generally can’t be refilled at short notice.
That said, if I can find you a makeup slot within two business days, I will. I’d far rather move an appointment than have you sit through one on a day when it isn’t going to be any use.
Can we use an HSA or FSA?
Frequently, yes — a good many health savings and flexible spending accounts cover therapy, and plenty of my clients pay that way. HSA cards work on my invoices. Confirm with your plan administrator, though, since the rules differ and I can’t speak for them.
Is there a reduced rate?
No. I don’t run a sliding scale and I don’t hold reduced-fee slots. If the fee is out of reach, the online course and the book Sex Without Stress cover a great deal of the same ground for considerably less.
Is anything else billable?
Phone calls, consultations, reports you ask me to write, and conversations with other professionals involved in your care are billed pro rata at the session rate.
Time spent on legal proceedings of any kind is billed at $500 per hour.
How many sessions will this take?
I don’t set a minimum and I won’t hold you to a package. Most couples are working with me for a matter of months rather than years — the aim is that you finish, not that you keep an appointment slot indefinitely.
Know what it costs. Ready to start?
Three short questions to check we’re a fit, and then the request form. If I’m not the right person for this, the last screen tells you where to look instead.