Frequently Asked Questions About Online Therapy with Tsuki LMFT

The standard fee for a 50-minute individual therapy session is $190.

Cancellations made with less than 24 hours’ notice, no-shows, or arriving more than 15 minutes late are billed the full session fee. This helps honor both our time and the structure of the work.

I’m an out-of-network provider, which means I don’t bill insurance directly. This allows us to focus on your care—without needing to justify sessions, assign a diagnosis, or limit our work based on what an insurance company considers “medically necessary.”

That said, many clients use out-of-network (OON) benefits to receive partial reimbursement for therapy. If your plan offers OON coverage, you have two options:

• Submit a superbill yourself (I’ll provide one monthly)

• Use Thrizer, a platform that can:

  • Check your benefits

  • Estimate your co-insurance in advance

  • Submit claims on your behalf

  • Track reimbursements or appeal denials

You’re not alone in navigating this—I’m here to help walk you through it.

I choose not to work directly with insurance companies because therapy should center your healing—not a diagnosis code or a third party’s limitations.

Insurance requires a formal mental health diagnosis and often limits how long, how often, and what kind of care you can receive. These restrictions can:

• Compromise your privacy by requiring sensitive records to be shared

• Pathologize human experiences like grief, stress, or trauma

• Reinforce inequities by making care harder to access for BIPOC, LGBTQIA+, disabled, and immigrant clients

• Pressure therapists to fit into short-term, one-size-fits-all models that ignore the impact of identity, culture, and systemic harm

By working outside of insurance, I can offer therapy that is:

• Slower, deeper, and more relational

• Rooted in liberation and equity

• Free from gatekeeping or imposed timelines

I know this system isn’t perfect. There are still barriers—and I’m still learning. But I’ve chosen this path because I believe it allows us to build care based on honesty, autonomy, and equity—not diagnosis codes and gatekeepers.

If you’re interested in learning more, the following articles offer in-depth explanations:

Therapy & Social Justice: Why Insurance Isn’t Our Path

Why I Don’t Accept Insurance As A Mental Health Therapist

Why Don’t Therapists Accept Insurance

Yes. I participate in several programs that help increase access to therapy:

• Asian Mental Health Collective's Lotus Therapy Fund – Covers the full cost of therapy for up to 8 sessions. If you’ve been awarded this fund, please send me your confirmation code before our first session so I can verify eligibility.

• Inclusive Therapists BIPOC Therapy Fund - This fund provides up to 12 fully covered sessions for Black, Indigenous, and Communities of Color/Global Majority with intersecting marginalized identities. These sessions are offered as part of my Tier 2 sliding scale and are limited in availability.

• Open Path Collective - Offers ongoing, low-cost therapy (not time-limited). My Open Path rate is $50 per session, and sessions are paid by the client directly. These spots are part of my Tier 1 sliding scale and are limited in availability.

Yes. To help make therapy more accessible, I reserve four sliding scale spots:

• Tier 1 – $50 per session (2 slots; 0 available)

• Tier 2 – $125 per session (2 slots; 1 available)

This sliding scale is one way I practice redistribution and collective care. It’s rooted in a belief that healing should be available across economic realities—not just for those with financial privilege.

You're invited to consider not just income, but your access to resources, safety nets, caregiving responsibilities, and systemic barriers. No documentation is required. I trust you to choose what feels honest and sustainable for you.

These spots are reassessed every 4–6 months to ensure they remain available for those with the greatest need. If all spots are currently full, you're welcome to inquire about being placed on a waitlist.

This model reflects a commitment to community care, economic justice, and shared sustainability. If you’re able to pay the standard rate—or more (Tier 3 or Tier 4)—thank you for helping make this model possible for others.

I use a trust-based, self-reflective approach inspired by the Green Bottle Method, developed by community healer Alexis J. Cunningfolk. This model centers access, agency, and collective care—not shame, judgment, or comparison.

You're invited to reflect on more than just income. Consider your access to financial and social resources, including:

• Income stability

• Personal or family debt

• Caregiving responsibilities

• Intergenerational wealth (or lack of it)

• Public assistance or financial safety nets

• How systems of power and oppression shape your access

There is no documentation required, and you’re never asked to explain or justify your choice. Healing begins with respect, trust, and relational safety.

Not Sure Which Tier Fits?

This isn’t about guilt—it’s an invitation to practice honesty and collective care.

Ask yourself:

• Do I have reliable access to housing and healthcare?

• Am I paying off large personal or family debt?

• Do I support others financially beyond myself?

These aren’t rules—just reflections. Let them guide you gently, without pressure.

Reflection Checklist

Before selecting a tier, consider how many of the following statements feel true for you:

• I own or lease a vehicle and can afford gas and maintenance

• I live in stable, secure housing

• I have savings or financial support from family

• I have reliable income that covers my basic needs (food, rent, etc.)

• I have health insurance or access to medical care

• I can take time off or travel without significant financial stress

• I can buy non-essential items (clothes, books, etc.)

• I have manageable or low debt

• I do not rely on public assistance

• I have a financial safety net for emergencies

Let your answers—not just the quantity, but how easily they apply—help guide your selection.

Fee Tier Guide

Tier 1 – $50/session (Accessibility Tier)
You checked 0–3 statements
You may be experiencing financial strain or difficulty meeting basic needs. This tier reduces barriers and increases access.

Tier 2 – $125/session (Sustainability Tier)
You checked 4–5 statements
You can meet basic needs and may have some support, but resources may still feel tight.

Tier 3 – $190/session (Standard Rate)
You checked 6–9 statements
You have steady income and financial access. Paying this rate supports sustainability and helps offer reduced-cost care to others.

Tier 4 – $190+ per session (Community Supporter Tier)
You checked all 10 statements
You have access to economic privilege. Paying above the standard rate expands therapy access for others. Thank you for being part of this collective care model and supporting equity in mental health.

Whatever tier you choose, please know it’s welcome and respected.
This system exists to honor your lived reality—not to test your worth.

I know this system isn’t perfect. There are still barriers—and I’m still learning. But I’ve chosen this path because I believe it allows us to build care based on honesty, autonomy, and equity—not diagnosis codes and gatekeepers.

My court policy is included in my informed consent and professional will. It states that I do not voluntarily participate in legal proceedings. If legal involvement is required, it clearly outlines my limitations and applicable fees.

If you are looking for a therapist who can support legal cases, I recommend seeking someone trained in forensic mental health or custody evaluations.

No. I do not provide court testimony, appear in court, or write letters for any legal or custody-related matters. This includes communication with attorneys, judges, or court-appointed professionals.

My role is to support your emotional and psychological healing—not to serve as a forensic evaluator or legal witness.

Because therapy and the legal system serve different purposes. Court involvement can:

• Compromise your confidentiality and therapeutic process

• Place me in a dual role that undermines the trust we build in therapy

• Require disclosures that may unintentionally harm your case

• Pressure therapists to act as neutral evaluators, which contradicts our therapeutic alliance

You are entitled to your records, but please be aware:

• Therapy records are clinical in nature and not written for legal use

• I do not provide summary letters or character references for court

• Records will only be released with a signed release of information from all relevant parties (e.g., both partners in couples therapy)

If I receive a subpoena:

• I will consult legal counsel

• I will invoke therapist-client privilege when applicable

• I will not release records without signed consent from all relevant parties

• I may be legally compelled to comply in rare cases

Yes. If I am required to participate despite my policy, the following fees apply:

• $2,000 per full day of testimony (in-person or virtual)

• $1,000 per half day of testimony (in-person or virtual)

• $200/hour for travel time (time spent commuting to and from the location)

• Reimbursement of all actual travel expenses (e.g., transportation, lodging, meals)

• All fees must be paid in full by cashier’s check 7 days in advance