Creating and supporting access to quality mental health care has always been Flyover Counseling's goal. That is why we offer telehealth services, and it is why our clinicians take insurance and Medicaid. In keeping with the goal of increasing access, Flyover Counseling has implemented an equity-based fee structure.

The intention is for counseling and mental health care to be as accessible as possible for as many people as possible. An equity-based fee structure is in keeping with a community-supported care model. People who are able to pay a higher amount for care without financial hardship are creating access to care for those who wouldn't be able to afford it without a lower rate.

A traditional sliding scale usually asks one question: what's your income? An equity-based scale asks a fuller one: what does your financial reality actually look like, once you account for debt, dependents, savings, health costs, and the systemic barriers like disability, caregiving responsibilities, discrimination, immigration status, and others, that can affect someone's income regardless of how hard they work?

Two people with the same income can have very different amounts of actual financial breathing room. Equity-based pricing tries to reflect that difference, rather than treating everyone at the same income level as though they're in the same position. Damien (2016) does a nice job of explaining the philosophy behind equity-based fee scales, and their work has influenced our implementation of this model.

We offer five tiers. None of them require proof of income. We ask you to place yourself honestly, using your own sense of your financial reality as the guide.

These tiers reflect the actual cost of providing care. If you're able to pay for the things you want (not just the things you need) without regularly worrying about it, if you have savings or assets you could draw on in an emergency, or if a request for financial help from family or a partner would likely be met without much difficulty, this is your tier. Choosing the full fee, when you're able to, is what makes the lower tiers possible for others.

This tier is for people who are managing but not entirely comfortable; they may have steady income, but little room to spare. You might be working on debt, building savings slowly, or living paycheck to paycheck without being in crisis. If the full fee would mean cutting into your ability to meet basic needs, but the reduced fee doesn't honestly reflect your situation either, this is likely where you belong.

These tiers are for people for whom the full fee would be a genuine barrier to care, if paying it would mean sacrificing something essential, like rent, food, healthcare, or transportation. This isn't a "discount" tier; it's built deliberately so that cost isn't the reason someone goes without the support they need.

If even the reduced fees are out of reach, please reach out and initiate a conversation about options. We want you to be able to access mental health care.

It can be genuinely hard to know which tier fits. One useful distinction, borrowed from writing on sliding-scale pricing more broadly: is paying a given fee a sacrifice or a hardship?

A sacrifice means you'd need to cut back somewhere else (fewer takeout dinners, a smaller entertainment budget), but nothing essential is at risk. A hardship means the cost would come at the expense of something you actually need. Sacrifice generally points toward the full or medium fee; hardship points toward the reduced fee (Cunningfolk, 2015).

We're not asking anyone to prove anything. A helpful counseling relationship is based on trust. We're asking for honesty, and trusting you to give it, the same way we'd want a client to trust us (Hawthorne, n.d.).

This is a common place to get stuck, so we included a short, private self-assessment to help. It asks a series of honest questions about assets, income, debt, and the kinds of systemic factors that shape financial access, and gives you a general sense of where you might fall on the scale. It won't tell you exactly what to pay (that's still your call), but it can make the decision less abstract.

Try the fee self-assessment →

Nothing you enter is saved, stored, or sent anywhere. It's a private tool for your own reflection, not a form we see. It places you on a five-point scale from Constricted to Abundant and maps that to a specific dollar figure within our tiers, so the result is more precise than "reduced, medium, or full" (Damien, n.d.).

This is a trust-based system. Just as we're trusting you to place yourself honestly, we're trusting that if your circumstances change, for better or worse, you'll let your clinician know so that your fee can move with you.

Tier availability isn't unlimited. Because reduced-fee spots are what make the whole structure work, we ask that you choose the tier that's honestly yours, rather than the lowest one available. If you can afford the full or medium fee, choosing it helps make space for someone who can't.

This applies across our clinicians. Every clinician at Flyover Counseling participates in this fee structure, so the tier you land on isn't specific to any one provider.

Insurance is still an option. If you have insurance and would rather use it than pay out of pocket at any tier, that continues to be available. The equity-based scale is for clients paying privately.

Group therapy and supervision are offered separately at a flat rate of $50 and are not part of this fee scale.

Cunningfolk, A. J. (2015, August 11). The sliding scale: A tool of economic justice (aka the green bottle method). Worts & Cunning Apothecary. https://www.wortsandcunning.com/blog/sliding-scale

Damien, H. (2016, May 9). Sliding scale: Why, how, and sorting out who. Ride Free Fearless Money. https://www.ridefreefearlessmoney.com/blog/2016/05/sliding-scale-1/

Damien, H. (n.d.). Sliding scale calculator & equity self-assessment. Ride Free Fearless Money. https://www.ridefreefearlessmoney.com/sliding-scale-equity-calculator.html

Hawthorne, B. (n.d.). Embracing an equitable sliding scale. Embracing Equity. https://www.embracingequity.org/post/embracing-an-equitable-sliding-scale

If you or someone you know is experiencing a mental health crisis or emergency, please contact one of the resources listed below immediately for immediate assistance.