Best Live Session Online Therapy

Amwell is the best online company offering flexible, pay-per-session therapy

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Live session online therapy already has changed the mental health community by helping increase access to lifesaving support for millions of people. Studies have shown that online therapy can be effective for patients with light to moderate depression, as well as panic disorder, social anxiety disorder, and generalized anxiety disorder. “Online therapy also enables those with disabilities to attend [therapy] who may not have been able to previously,” Stefanie Juliano, MS, LPCC, told Verywell Mind. “It can also help reach those who are of lower socioeconomic status.”

While many online therapy companies offer monthly subscriptions for therapy, some adopt a more flexible business model that is similar to in-person therapy: You can pay per session which provides an extra layer of convenience if you’re not sure how often you’ll want to have live sessions. Paying per session may also encourage more people to try therapy because they’re not locked into a commitment. However, it does tend to be more expensive than an online therapy subscription, especially if you don’t have insurance or if your online therapy isn’t covered by your insurance. Here are the companies that came out on top in our reviews.

Best Live Session Online Therapy of 2022

Best Overall : Amwell


Key Specs
  • Cost: $109–$129 per session with a therapist: $279 for first appointment with a psychiatrist, $109 for follow-up appointments
  • Accepts Insurance: Y
  • No. of Therapists: More than 100
Why We Chose It 

You can make an appointment with a therapist or psychiatrist practically anytime, day or night, weekdays or weekends.

Pros & Cons
Pros
  • Accepts many insurance providers

  • Psychiatrist bios online

  • Medication management

Cons
  • No free consultations

  • Live video sessions only

  • More expensive than subscription-based

Overview

Amwell is one of the few online therapy services that offers the flexibility of paying per session and holding them at almost anytime. It has accredited psychiatrists and psychologists available 24/7, 365 days per year—though if you want a therapist who can work with an unconventional schedule, you might have more limited options. 

Amwell offers a wide range of therapy services, including family therapy, couples’ therapy, and adolescent care. You can choose a provider who best fits your specific needs. It also has therapists equipped to manage acute symptoms and psychiatrists for medication management. Live mental health sessions are 45 minutes long and can be booked to fit your schedule at your convenience.

Amwell has a high overall customer satisfaction rating with the users we surveyed: 77% said the overall services they received with Amwell were either very good or excellent, while 81% said their therapist’s qualifications were excellent or very good. Eighty-eight percent said they either were likely or very likely to recommend Amwell and 78% said its value was very good or excellent for the money spent.

Best for Psychiatry : Plushcare


PlushCare

PlushCare

Key Specs
  • Cost: $99 per session or $119 if you don’t opt for weekly sessions; medication management is $49 per month 
  • Accepts Insurance: Yes
  • No. of Therapists: N/A
Why We Chose It

Plushcare offers flexible, pay-per-session therapy along with medication management with a primary care physician for a low monthly fee.

Pros & Cons
Pros
  • Affordable medication management

  • Free, 30-day trial

  • Can cancel sessions same day without charge

Cons
  • Can’t view therapist bios without signing up

  • Not available in all states

  • Expensive

Overview

Medication management is an essential part of mental health care for many people, but it can be expensive and difficult to access, especially if you’re unable to work within a traditional therapist’s schedule. Plushcare aims to bridge that gap by offering talk therapy and simple, remote medication management for a low monthly fee, with your prescriptions delivered to your door.

It also offers the flexibility of pay-per-session therapy with accredited therapists who specialize in most mental health needs.  Once you sign up with one, you also get access to Plushcare’s primary care physicians who can prescribe and treat a number of general health issues. The mission is to simplify health care so people who’ve had trouble getting the support they need for whatever reason can have easy access to care.

Plushcare treats a number of mental health issues including depression, anxiety, stress, sleep disorders, and panic attacks. However, it’s not equipped to treat families, couples, or people younger than 18.

Best for Anxiety : Teladoc Health


Teladoc

Teladoc

Key Specs
  • Cost: Depends on insurance coverage: $99 per session without insurance; psychiatric: $299 per session, follow-ups: $119 per session
  • Accepts Insurance: Yes
  • No. of Therapists: N/A
Why We Chose It

Teladoc is a veteran telehealth company that may help reduce your anxiety through talk therapy and medication management.

Pros & Cons
Pros
  • Long track record of success

  • Works with numerous insurance plans

  • Widely available

Cons
  • Can’t see therapist bios without account

  • Expensive without insurance

  • One part of a much larger health service company

Overview

Online therapy has been a game-changer for people with anxiety. It can help reduce the impact of some key triggers like travel and in-person meetings, all while still providing the kind of professional support you can expect from traditional therapy.

Teladoc has been around for nearly 20 years and is well-versed in all forms of telemedicine. You can talk to its accredited therapists in live video or audio sessions every day of the week during normal business hours. You can manage your medication with Teladoc as well, and it will deliver to you in case traveling to the pharmacy is challenging. 

If you need to cancel, you can do so up to two hours ahead of time at no charge. You’re billed per session, allowing for flexibility to make use of the service only when you need it. If you don’t have insurance, the monthly cost is a bit above average compared to the other companies we surveyed.

Teladoc Health has a high overall customer satisfaction rating with the users we surveyed: 80% said their therapist’s qualifications were excellent or very good, 95% percent said they either were likely or very likely to recommend Teladoc, and 88% said they were likely or very likely to still see a Teladoc therapist 12 months from now. However, only 66%  said the overall services they received with Teladoc Health were either very good or excellent.

Best for Depression : MDLIVE


MDLive

MDLive

Key Specs
  • Cost: $108 for therapist session, $284 for psychiatrist session (without insurance)
  • Accepts Insurance: Yes
  • No. of Therapists: N/A
Why We Chose It 

MDLIVE helps you flexibly manage a number of mental health needs with talk therapy and/or medication management.

Pros & Cons
Pros
  • Pick your own provider

  • Medication management

  • Treats a number of behavioral needs

Cons
  • Expensive medication management without insurance

  • Have to sign up to see all therapist bios

  • 24-hour session cancelation policy

Overview

MDLIVE aims to be a lifeline for those struggling with the sometimes debilitating effects of depression. 

MDLIVE’s providers specialize in treating depression with talk therapy and/or medication management. They also treat many other common behavioral health issues including trauma, grief, and bipolar disorder, in addition to providing parenting support.

Once you fill out the questionnaire, you can browse through its qualified, accredited therapists and find one who matches your needs. With insurance, you can pay as little as $0 per session or up to $108 without insurance. If you feel like medication would help, you can see a psychiatrist for up to $284 per session. If you have insurance, your co-pay will vary depending on your provider.

Paying per session offers you more flexibility than a subscription therapy service, but it does come at a higher cost if you don’t have insurance. If you have questions or concerns before or after you sign up, MDLIVE has trained health specialists available by phone 24/7/365.

MDLIVE has a high overall customer satisfaction rating with the users we surveyed: While only 67% said the overall services they received with MDLIVE were either very good or excellent, 94% percent said they either were likely or very likely to recommend MDLIVE and 90% said they were likely or very likely to still be seeing an MDLIVE therapist 12 months from now.

Best for Grief Counseling : Doctor on Demand


Doctor on Demand

Doctor on Demand

Key Specs
  • Cost: $129 for a 25-minute session and $179 for a 50-minute session; psychiatry initial visit is $299 (without insurance)
  • Accepts Insurance: Yes
  • No. of Therapists: N/A
Why We Chose It 

Doctors on Demand offers easy-to-access talk therapy and medication management any time you need it.

Pros & Cons
Pros
  • Services for both adults and children

  • Choose your therapist

  • Medication management

Cons
  • Fewer therapists available compared to other services

  • Features can be overwhelming

  • Lack of customer service

Overview

Doctors on Demand is one of the few online therapy companies we reviewed that specializes in providing therapy and support for people who have recently experienced a loss or are struggling with grief. Many of these accredited therapists have ample experience helping people through loss and grief-related symptoms such as depression and trouble sleeping. Once you choose a therapist based on their bio, you can schedule your first appointment. Some of our reviewers did run into bugs on the website, but using Doctors on Demand’s mobile app seems to help circumvent those issues.

In addition, the sign-up process quick and painless. It takes you through a simple, two-minute assessment before showing you how you rank in terms of your depression and anxiety levels, then leads you to the bios of therapists who can help. If medication is part of your mental health needs, they walk you through how to get your prescriptions filled and sent to your home.

Since Doctors on Demand allows paying by session, you don’t have to worry about staying on a regular schedule with your therapist. This does mean, however, that you’ll be paying slightly more than the average cost of the companies we surveyed for each 25- to 50-minute session if you don’t have an insurance plan that's accepted. If you do, however, Doctors on Demand makes it relatively simple to see if your plan offers coverage, and what, if any, your co-pay will be.

Doctors on Demand has a very high overall customer satisfaction rating with the users we surveyed: 75% said the overall services they received with Doctors on Demand were either very good or excellent; 90% percent said they either were likely or very likely to recommend Doctors on Demand, and 88% said they were likely or very likely to still be seeing their therapist after 12 months. However, only 58% said its value was very good or excellent for the money spent, likely due to the higher than average out-of-pocket costs if you don’t have insurance.

Best with Insurance : Talkiatry


Key Specs 
  • Cost: Depends on insurance carrier
  • Accepts Insurance: Yes
  • No. of Therapists: 30+ accredited psychiatrists 
Why We Chose It

Talkiatry partners with a wide range of insurance carriers to bring affordable mental health care to more people. 

Pros & Cons
Pros
  • Accepts lots of insurance providers

  • Psychiatrist bios online

  • Medication management services

Cons
  • Not ideal for people without insurance

  • No fee information provided

  • Currently only servicing New York state

Overview

Talkiatry works with many insurance providers to make therapy and medication management with an accredited psychiatrist much more accessible. 

Talkiatry is the only company out of the 33 we reviewed that focuses solely on meeting psychiatric needs. Its user-friendly site clearly explains how insurance works with psychiatry, answering many questions someone new to online therapy might have about coverage.

You do have to fill out a lengthy assessment in order to sign up for the service, but you can then choose a psychiatrist from the more than 30 qualified and experienced professionals who work with Talkiatry. After that, you can create an account to get access to your patient portal, where you’ll schedule your first appointment. Talkiatry allows you to pay by session, so you don’t have to stick to a regular schedule. 

Most Affordable Without Insurance : Peer Collective


Key Specs: 
  • Cost: $14–$28 per session
  • Accepts Insurance: No
  • No. of Therapists: N/A
Why We Chose It

Peer Collective helps make online counseling flexible, accessible, and affordable.

Pros & Cons
Pros
  • Can choose counselors from a long list of matches

  • Free 60 minutes upfront

  • Easy to sign up and start sessions

Cons
  • Insurance not accepted

  • No medication management services

  • Counselors are not licensed therapists

Overview

Peer Collective is one of the few providers that aims to make mental health support more accessible by being one of the most affordable companies out there without insurance.

On Peer Collective, you can live chat with a “peer counselor” for as little as $14 for a 30-minute session and $28 for a 60-minute session. These counselors are not licensed therapists, but rather counselors who have experience with many different mental health issues. You can schedule sessions with your counselor on live video, and since you pay by session, you don’t have to worry about meeting a monthly quota or cutting back on sessions because of time or financial constraints.

You do have to complete a questionnaire in order to read the counselors’ bios, but it's pretty basic. Note that the site also doesn’t have much in terms of educational resources.

Best for Couples : Our Relationship


Key Specs
  • Cost: $150 one-time fee
  • Accepts Insurance: No
  • No. of Therapists: 20 coaches
Why We Chose It 

Our Relationship offers self-driven programs and live counseling to help couples address any mental or emotional issues.

Pros & Cons
Pros
  • Bios of coaches available on website

  • One-time fee

  • You can pick your coach

Cons
  • Coaches are mainly doctoral students

  • More self-help than therapy

  • Not for couples needing long-term help

Overview

Our Relationship gets that couples deal with all sorts of emotional and mental health issues that can weigh heavily on any relationship. It also recognizes that people are busy and don’t often have the time to sit down for regularly scheduled meetings with a therapist. That's why the company offers self-driven programs designed to help couples learn to communicate better and that can fit in with their lives. And Our Relationship is inexpensive compared to the other companies we reviewed.

Couples can choose a coach to help guide them through the program. The company offers a number of qualified therapists with ample experience in relationship therapy and claims to have helped more than 5,000 people improve their relationships through its online programs. 

According to their bios, their coaches are well-versed in treating all kinds of couples, from military couples to same-gender couples. However,  if you think you and your partner need more intensive therapy, this probably is not the site for you. 

Our Relationship has a high overall customer satisfaction rating with the users we surveyed:

  • Ninety-five percent said they either were likely or very likely to recommend it to someone like them.
  • Eighty-seven percent said its therapists were well-qualified.
  • Seventy-one percent said Our Relationship’s services overall were either very good or excellent.
  • Seventy-three percent said its value was very good or excellent for the money spent.

Best for LGBTQIA+ : Kip


Key Specs
  • Cost: $75–$175 per session
  • Accepts Insurance: No
  • No. of Therapists: 40
Why We Chose It 

Kip prides itself on being an inclusive online therapy service catering to the mental health needs of the LGBTQIA+ community.

Pros & Cons
Pros
  • Unique online classes

  • Couples, family and group therapy

  • Cn choose your therapist

Cons
  • Serves New York state only

  • Doesn’t accept insurance

  • No text-based therapy

Overview

Once a traditional, brick-and-mortar therapy office focusing on sexual orientation and gender identity issues, Kip moved online in 2020 to reach more people in need of its services. Many people in the LGBTQIA+ community may feel ostracized by the health care community, but Kip’s goal is to create an online therapy community that does the opposite. As the homepage on its website succinctly states: “Kip is a space where you can find the support, understanding, and expertise to guide you toward a place where you belong.”

Diversity and sensitivity are the pillars of Kip. Its collection of therapists is well-trained to support every aspect of its clients’ identities and experiences and help them cope with any struggles. You can read therapists’ bios on Kip’s intuitive website, and if you connect with someone, there’s a button to check their availability right there.

Instead of filling out a questionnaire, you schedule a 45-minute intake session with your therapist of choice get acquainted, and find out what you’re looking to achieve. Sessions cost $75 to $175, depending on which tier of therapists you choose and the type of therapy you’re interested in. Unfortunately, Kip doesn’t take insurance, so its rates might be cost-prohibitive for some. It also only serves the NY area. 

Kip Therapy has a high overall customer satisfaction rating with the users we surveyed: 75% said Kip’s services overall were either very good or excellent, 88% said they either were likely or very likely to recommend it to someone like them, and 79% said its therapists were well-qualified. Seventy-six percent said its value was very good or excellent for the money spent.

Final Verdict

All of the online therapy services on this list offer the flexibility of paying per session as well as the convenience of live video sessions. Amwell, however, is our top choice based on all it offers for the cost. Amwell connects you with psychiatrists and licensed therapists so you can manage your medication and talk therapy all in one place, and it does so at a lower per-session price than most other online therapy services we surveyed that include medication management. Its therapists are all accredited, treat a wide variety of mental health issues, and are available for sessions any day of the week, day or night, even on holidays.

Compare the Best Live Session Online Therapy

Company Price App Available Platforms Insurance
Amwell
Best Overall
$109–$129 per session; psychiatric $279–$109 Yes Live video and audio Yes
Plushcare
Best for Psychiatry
$109–$129 per session, psychiatrist: $279. Follow-up appointments are $109 Yes Live video and audio, messaging Yes
Teladoc
Best for Anxiety
$99 per session; psychiatric $299-$119 without insurance Yes Live video and audio Yes
MDLIVE
Best for Depression
$108 for therapist session, $284 for psychiatrist session (without insurance) Yes Live video and audio, messaging Yes
Our Relationship
Best for Couples
$150 one-time fee No Live video and audio No
Peer Collective 
Best without Insurance
$14–$28 per session  No Live video, phone No
Kip
Best for LGBTQIA+ 
$75 up to to $175 per session No Live video and audio No

Frequently Asked Questions

How Much Do Pay-Per-Session Live Sessions Cost?

Some pay-per-session online therapy services accept insurance, which can reduce the cost per session to a small copay or no copay. However, if you don’t have insurance, pay-per-session online therapy tends to be more expensive than subscription-based. If you aren’t scheduling sessions weekly, it may be more cost-effective, but if you’re looking to see a therapist more often, a subscription-based service may be a better option.

Is Pay-Per-Session Online Therapy Right for You?

Live session online therapy offers a level of flexibility unlike what you’ll find with traditional therapy. You can have all of your sessions from your home, which helps cut out limitations for people with disabilities or scheduling and location constraints. The live chat function most online therapy services offer allows you to have a one-on-one conversation with your therapist like you would if you were in the same room.

Paying by session also means you can take breaks from therapy if you need to. Some online therapy services also give you the ability to message a therapist at any time, day or night—which can be extremely helpful if you just want to have a quick check-in rather than a full-length session.

Is It Easier to Switch Therapists if You Pay per Session for Online Therapy?

Based on our research, it’s just as easy to switch therapists whether you use a pay-per-session service or a subscription service. Some companies, like Teladoc and Doctors on Demand, also have general practitioners available and are used to people switching doctors, so the process is simpler than a subscription that matches you with a therapist. In the latter case, you may have to contact customer service to make the switch.

Does Insurance Cover Live Video Session Online Therapy? 

Insurance coverage depends on the online service you choose. Some services, like Plushcare and Amwell, partner with several common insurance companies, so you might want to try them first if out-of-pocket costs for online therapy sessions would be prohibitive.

Some live video session online therapy services give you a receipt for your sessions so you can submit them to your insurance company for reimbursement if they’re considered out of network.

You also may be able to pay for your therapy with a health savings account (HSA) or flexible spending account (FSA) card if you have one or get assistance with costs via an Employee Assistance Plan (EAP) if your employer provides one.


What Should I Consider When Comparing Pay-Per-Session Online Therapy Services?

When considering moving ahead with live session online therapy, there are several factors that are important to consider when selecting a service:

  • Communication platforms: Are live calls with your therapist important, or would live messaging suffice?
  • Scheduling flexibility: This is especially helpful for people who need an appointment during unconventional hours.
  • Cost: Paying by session sometimes can be cost-prohibitive, but some services try to make it more affordable by offering financial aid or tiered pricing based on the therapist's experience.
  • Accepts insurance: If you have insurance, make sure the service you use accepts your provider.
  • Therapist qualifications: Does having a licensed, accredited therapist matter to you?
  • Ease of use: Does the service have an app or require you to use a special portal to have therapy sessions?

Methodology

Our methodology for evaluating online therapy companies is comprehensive and data-driven. To fairly and accurately review the best online therapy programs, we sent questionnaires to 33 companies and surveyed 100 current users of each. This allowed us to directly compare services offered by gathering qualitative and quantitative data about each company and its users’ experiences.

Specifically, we evaluated each company on website usability, sign-up process, subscription offerings, client privacy protections, and the ease of changing therapists. We then looked at therapist qualifications, the types of therapy offered quality of care, client-therapist communication options, session length, and the therapist assignment process. Finally, we assessed cost, value for money, insurance acceptance, overall user satisfaction, and the likelihood clients would recommend the company. 

Edited by
Simone Scully
simone-scully-verywell

Simone is the health associate editorial director for performance marketing at Verywell. She has over a decade of experience as a professional journalist covering mental health, chronic conditions, medicine, and science.

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Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Dockweiler C, Kupitz A, Hornberg C. Acceptance of online-based therapy by patients with light to moderate depressive disorders. Gesundheitswesen. 2018;80(11):1013-1022. doi:10.1055/s-0043-119287