Trichotillomania Therapy Cost: Fees, Insurance and Sessions

Working out the trichotillomania therapy cost before you book can feel awkward, because many practitioners don’t list prices and most people don’t know how many sessions they’ll need. This guide covers what a session typically costs where you live, what insurance and public health services may pay for, and how long a course usually lasts, so you can plan a budget.

Trichotillomania (trich) is a body-focused repetitive behavior (BFRB): a condition where people repeatedly pull, pick or bite at their own hair, skin or nails. It affects about 1 in 50 people. Each practitioner sets their own fee, so the figures below are typical prices for private talking therapy, not special trich rates. We checked them in September 2026. Fees change, so always confirm the price before you book.

What does a session of trichotillomania therapy cost?

It depends on your country and on who you see. Fees are set by each practitioner, and psychologists often charge more than counselors.

In the US, a 2024 study looked at the prices listed by more than 175,000 private therapists on a large online directory. In late 2023 the average cash price was about $143 a session. Prices varied by state and by type of therapist. About two in three therapists accepted some insurance, and about one in three accepted none.

At that average, a course of 10 sessions would cost about $1,430 before any insurance.

Does insurance cover trichotillomania therapy?

Often, at least in part, but it depends on where you live and on your policy. Trichotillomania is a recognized diagnosis with its own code (F63.3 in ICD-10, the international list of diagnoses), and insurers generally need a diagnosis code before they pay.

Many US health plans cover mental health care. Marketplace plans (the plans you buy through HealthCare.gov or your state’s exchange) must cover behavioral health treatment, such as psychotherapy and counseling, as one of 10 essential health benefits. Under federal parity rules, if a plan covers mental health care, its copays, deductibles and visit limits can’t be stricter than those for medical care.

The harder part is finding someone who takes your insurance. If your practitioner is out of network, your plan may pay back part of the fee after you’ve paid. You’ll usually pay more: for example, a share such as 40% of the amount your plan allows, plus anything the practitioner charges above that amount. Ask your practitioner for an itemized receipt showing the diagnosis and treatment codes, and send it to your insurer.

Our guide to using out-of-network benefits and superbills explains how to claim, step by step.

How many sessions might I need?

Most people have around 8 to 12 weekly sessions, though some need fewer and some more. Knowing this lets you budget for a course rather than a single appointment.

A typical course is around 8 to 12 weekly sessions, sometimes with a check-in later.

The best-studied approach is Habit Reversal Training (HRT). It teaches you to notice the urge to pull and to do something else with your hands instead. Trials give a sense of how long a course takes:

Study	Who	Sessions
Franklin and colleagues, 2011	24 young people aged 7 to 17	8 weekly sessions of behavior therapy
Woods and colleagues, 2022	85 adults	10 sessions over 12 weeks of behavior therapy with acceptance skills

A 2014 review of 11 trials found that behavior therapy worked better when people spent more hours with their therapist. That doesn’t mean more is always better for you, but it’s a reason not to stop after two or three sessions if you’re making progress.

Much of the progress happens between sessions, when you practice the skills in daily life. Some people also book an occasional follow-up later, for example during a stressful time or after a setback. You can read more about how it works in our guide to Habit Reversal Training.

Are there free or lower-cost options?

Yes, in most countries, though waits can be long and you may need to explain what trich is.

Public services, insurance, workplace schemes and lower-fee options can all bring the cost down.

Sliding-scale fees: some practitioners charge less if your income is lower. Ask when you book.
Community health centers: health centers funded by HRSA (the Health Resources and Services Administration) adjust fees to income and family size, serve people who can’t pay, and have therapists and social workers on staff.
Training clinics: many universities and medical schools run clinics where trainees see clients under supervision.
Medicaid covers mental health care for people who qualify. FindTreatment.gov, run by the federal mental health agency SAMHSA, can help you find services near you.

What should I ask before I book?

Ask about money at the start. A good practitioner won’t mind, and it saves surprises later.

What is the fee per session, and how long is a session?
Is the first appointment a different length or price?
What is your cancellation policy?
Can you give me receipts or paperwork I can use for insurance, rebates or tax relief?
Do you offer reduced fees for people on lower incomes?
Have you helped people who pull their hair before, and what approach would you use?
Roughly how many sessions do you expect I’ll need, and how will we check progress?
Do you offer online sessions?

Our guide to questions to ask a therapist before you book goes further.

Where can I find someone who understands trich?

Get support if pulling is causing you distress, taking up a lot of your time, or affecting your life, work, school or relationships. You don’t need to wait until it’s “bad enough”.

Many doctors and therapists have never worked with someone who pulls. Everyone in our directory has told us they understand trichotillomania and already help people who pull, in person or online. You can search the directory.

Our guide to finding a therapist who understands trichotillomania explains what to look for.

If you’re a parent reading this for your child, start with The Parent’s Guide to Trichotillomania: understanding what your child is going through.

Questions people ask

Is a psychologist more expensive than a counselor?

Often, yes. In Ireland, for example, the HSE puts private counselors at €60 to €100 a session and private psychologists at €90 to €180. For trich, what matters most is whether the person understands hair pulling and can explain clearly how they’ll help you.

Can my doctor refer me for trichotillomania therapy?

Often, yes. In the UK, the NHS says a GP may refer you for cognitive behavioral therapy (CBT), and under-18s may be seen by children and young people’s mental health services. In other countries, a doctor can point you to public services or write the referral that some insurers and rebates need.

Do I need a diagnosis to claim therapy on insurance?

Usually. Insurers generally need a diagnosis code on the claim. Trichotillomania has its own code, F63.3 in ICD-10, which your practitioner or doctor can record if they’re qualified to diagnose. Ask before you start whether their receipts will include the codes your insurer needs.

Can I use a workplace employee assistance program for trich?

If your employer has an employee assistance program (EAP), it may offer free, confidential counseling. It can be a useful place to start. Ask how many sessions are included, and whether they can refer you to someone who understands hair pulling if their counselors don’t.

What if I can’t afford a full course of therapy?

Tell the practitioner at the start. Some offer reduced fees for people on low incomes, and some may agree to space sessions further apart once you’ve learned the core skills. Practice between sessions, since much of the progress happens there, and check what free public services exist where you live.

Does therapy for trichotillomania cost more than other therapy?

There’s no standard price for trich therapy. Each practitioner sets their own fee, and the price ranges in this guide are for private talking therapy in general. The bigger difference in your total cost usually comes from how many sessions you need, so ask how many they expect.