Panorama Therapy | Miranda Nadeau PhD, Psychologist in 39+ States

Frequently Asked Questions

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How We Work

Panorama Therapy is honored to offer LGBTQ+ therapy, BIPOC therapy, multiracial therapy, and Asian American therapy in Texas, New Jersey, Washington, Nevada, Illinois, and 30+ more states via telehealth. When the world went online in 2020, we were concerned about whether virtual therapy would mean lower-quality care. Despite this, we were pleasantly surprised to find that telehealth is just as deep and transformative as in-person therapy. Psychological research also speaks to the power of virtual therapy. Provided you have a private space to meet and a strong internet connection, research shows that online therapy is equally as effective as in-person!

A map of the US, featuring the 39 states where PSYPACT is active and Miranda Nadeau can practice therapy

We treat clients across the country, in 39+ states including these. If you’re located in one of these states, we’d love to work with you: Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, Washington D.C., Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, & Wyoming

These states have adopted into law the Psychology Interjurisdictional Compact (PSYPACT), which allows some psychologists who meet strict criteria to practice therapy across state lines. Psychologist Miranda Nadeau, Ph.D. enjoys forming strong connections with faraway clients. Schedule Your Free Consult

Native Land Acknowledgement

Dr. Nadeau offers her services from the ancestral and unceded land of the Munsee-speaking Lenape peoples, who cared for this land as their home. To this day, individuals from a wide range of Indigenous backgrounds call this area home. We are grateful for the contributions and sacrifices of these peoples, the traditional caretakers of the land. We honor and thank all the Indigenous people connected to this land. For more information about this land acknowledgment, see this guide to honoring native land.

The below fees are for therapeutic services with Miranda Nadeau, Ph.D. Other psychologists may be available with different rates; please inquire to learn more. 

$220 Intake session. Fees for the exploratory initial session and evaluation include the following:

  • Your first therapy session
  • Intake documents
  • The informed consent process
  • Taking your biopsychosocial history
  • Any necessary initial assessments
  • Clinical evaluation
  • Treatment planning
  • Creation of your private, secure therapy file

$220 Ongoing therapy session

Prorated fee Extended sessions arranged in advance

Your copay Therapy sessions in network with insurance

$60 Group therapy

Pro bono or reduced fee available Trans and gender expansive clients seeking referral letters and therapy


Scheduled Time: Payment is based on the time you reserve. In the event you are late to your appointment, you will meet with your therapist for the remaining scheduled time, and the full fee will be charged. Similarly, if you decide to end the session earlier than was scheduled, a refund will not be provided for the remaining reserved time.

Why does therapy cost as much as it does? This article by HuffPost titled “Why Is Therapy So Expensive?”  is a great resource that provides some background into the pricing for therapy and explains the reasons for the high costs of therapy.

Good Faith Estimates: All clients have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

      • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
      • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
      • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
      • Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit

Payment is due at the time of each session. When you complete intake paperwork, you’ll be asked to place a card on file (credit or debit, FSA, or HSA card). We’ll run your card on file for each scheduled session. Alternately, send electronic payment before your session to forego the card charge.

We consider it unethical for therapists to allow clients to accumulate significant debt regarding therapy; therefore, future sessions will not be scheduled while there is a balance on your account.

We accept all credit cards, debit cards, FSA cards, HSA cards, and electronic transfers.


In-network: We accept many BCBS/Anthem/Horizon PPO insurance plans, though therapists accepting BCBS can vary according to when you reach out. Our front office staff will share with you the most updated info on who’s in-network and has availability to meet with you. To get started with in-network therapy, be sure to mark BCBS on our contact form and optionally provide your insurance info (we’ll just need your subscriber ID & date of birth at this stage).

Out of network: For all other insurance plans, our services may be covered through your out-of-network benefits. Read below about how this works.

We understand that affording therapy and navigating the world of insurance can seem a bit overwhelming, especially if we’re not in-network with your insurance company. Rest assured, therapy is often affordable and accessible through the out-of-network benefits in the insurance plan you already have now. We are here to help with the process. Here’s what the process looks like for using your insurance at Panorama Therapy.

1. Explore Your Out-of-Network Benefits

Look in your insurance company’s online portal, consult your list of benefits, or contact your insurance provider to understand your out-of-network mental health benefits. Learn about whether you need to meet an out-of-network deductible, and if so, learn the dollar amount of that deductible. Also learn about coverage percentages for coinsurance/copay, or how much of each session’s fee you may be responsible for. You can also ask about any limits or caveats to the policy. Gathering this information is an excellent first step.

2. Superbills – Your Key to Reimbursement

Get started with therapy and let us know you plan to use out-of-network benefits. At each therapy session, you’ll owe the full fee upfront. At the end of every month, we provide you with a detailed receipt called a “Superbill.” This document includes all the necessary information your insurance company needs, like a diagnosis required to use the insurance benefit and relevant CPT codes that describe the services you’re receiving.

3. Submit Superbills for Reimbursement

Each month, you can submit the Superbill to your insurance company for review and reimbursement. They’ll call this “claims submission.” The process will differ depending on your insurance provider, so call them up or look in your portal for how to submit out-of-network claims. After you submit them, be prepared to twiddle your thumbs a bit as insurance companies take time to send your submission through their system.

4. Receive Reimbursement

Depending on your exact benefits, your insurance provider then sends you a check or uses direct deposit to reimburse you for some of what you paid for your sessions. The exact amount will depend on the details you learned in step 1, but many plans pay 70% to 90% of session fees. What you don’t get reimbursed back is the coinsurance or copay you’re responsible for. Note that you may need to “meet your deductible,” or surpass a certain threshold of medical spending for the year, before your insurance company will reimburse you—you learned that in step 1 as well!

5. Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs)

If you have an FSA or HSA, you can use these funds to pay for sessions at Panorama Therapy. This can be a great way to save on taxes and bills in general.

6. Tax Deductions

Keep in mind that you may be eligible for tax deductions on therapy expenses. Consult a tax professional or read about it on the IRS website to explore this option.


We care about your well-being and are committed to making therapy accessible. Don’t hesitate to reach out if you have questions or need assistance navigating this process.

Are you unable to afford therapy after exploring your out-of-network benefits? Ask if your therapist currently has any sliding scale spots open or look up options for community mental health services in your geographic location.


Many clients opt to pay for therapy privately, or “out of pocket,” rather than using any insurance benefits. There are several reasons why this can be a good idea.

1. Declining a diagnosis. Because using insurance benefits means meeting criteria for ‘medical necessity,’ therapists are required to provide a mental illness diagnosis for you and share it with your insurance company. This diagnosis can stay in your files and impact you throughout your life. Privately paying for therapy means skipping the pathological approach to your care and making diagnosis an optional treatment aid rather than a necessary fact.

(Note: This is especially critical for couples therapy, for which insurance companies dictate that a single person in the couple is designated the “identified patient” with a diagnosable problem. Our therapists don’t work in that model of pointing fingers at one problematic partner; instead, the couple as a unit is seen as the client. Insurance rarely covers couples therapy.)

2. Protecting your privacy. Clients are often concerned about the level of privacy they can maintain over their information once it’s shared with a large managed care company. Maintaining a higher level of confidentiality and security around personal information is a common reason clients opt not to use their insurance benefits for therapy.

3. Maintaining your autonomy. Paying privately for therapy increases autonomy and choice by removing all requirements and limits related to therapy length, type, treatment, and approaches. For example, using insurance means the insurance company dictates how long you and your therapist can meet, both in terms of session length and the number of sessions you’re able to have. Out-of-pocket payment ensures you are in the driver’s seat of your own care. It also allows you to keep your therapist even if you happen to change jobs or insurance providers.

4. Focusing on therapy. Finally, privately paying for therapy allows therapists to dedicate more time to preparing for a client’s sessions, rather than using that time for administration and negotiation with the insurance company. This time is most often used to review notes related to your care, engage in consultation or clinical supervision, attend workshops, or read relevant books. The ultimate result is more focused and personalized therapy sessions that are better suited to your needs.


There are many reasons why clients prefer private pay therapy. If you’re curious about paying out of pocket, we encourage you to speak with your therapist about your options during your introductory phone consultation and see if this might be a good fit for you.

Our therapists have varying schedules throughout the week. Currently available clinicians offer sessions that start between 10:00 Central/11:00 Eastern (8:00 Pacific) and 4:00 Central / 5:00 Eastern (2:00 Pacific), Mondays to Fridays. Please let us know of your scheduling needs when you reach out to us.

Please fill out our contact form to get started with online therapy. Our office staff will connect you with Dr. Miranda Nadeau or another psychologist who may be a good fit for you. Be aware that there may be a wait to meet with someone.

When you schedule an appointment, that time is reserved for you. If you cannot attend your appointment, please provide notification as soon as possible and at least 48 hours in advance to avoid any charges. With less than 48 hours’ notice, you are agreeing to pay for the time you reserved, and you will be billed for a full session. We must charge a full fee if you cannot make your appointment and you do not cancel the appointment at least 48 hours in advance. For clients using insurance, you will be charged a $60 fee for missed/late-cancelled sessions. Emergency situations can be discussed at your earliest convenience.

Our online therapy platforms work best when your internet connection is solid and high-speed, but even then, all technology has its limitations. The technology we use to meet may fail on occasion, due to internet connection issues, hardware or software malfunctions, or issues with third party services that are out of our control. While we can’t guarantee a seamless appointment every time, if we’re all willing to be flexible, we can still ensure we’re able to meet for your appointment.

As a practice, we maintain multiple communication channels for exactly these situations. In the event that we encounter any technical difficulties during our session,  your therapist will first try to troubleshoot the problem using the chat feature of the video application. If that doesn’t work or isn’t available, we will switch to another application (telehealth video platform) or communicate through phone, text, or email to complete the session. While technical issues may compromise the typical platforms we use in session, we will work with you to still complete a worthwhile session.

Especially because of the above, it’s important that you keep your therapist informed of any changes in your phone number or email address. This way, we can reach you if we ever experience any technical issues. Similarly, please keep our contact information handy in case of any issues on your end.

How Therapy Works

We are so glad you’re starting on this courageous journey. We’ll meet together after our introductory phone consultation, where we might discuss why you’re seeking therapy and how we can help. In your exploratory intake therapy session, you can expect us to talk about what’s impacting your mental health and your goals for our work together. We will also ask questions to better understand the context of your concerns, learn about your strengths, and ensure we’re the best fit for your needs.

This initial session is also an opportunity to start forming our working alliance. The therapeutic relationship is critical to whether therapy will ‘work’ and that connection begins from day one. As we form our alliance, our relationship creates a protected space where you can open new doors in your self-exploration and make transformative changes. Contact us to book your free introductory consultation and make plans for our first session.

The single best predictor of how helpful therapy will be is how you feel in your relationship with your therapist. Are you comfortable speaking with your therapist, and do you feel seen and heard by them? If you feel a connection with your therapist, you’ve probably found a good fit. We’ll help you find your good fit, whether that’s an inclusive therapist at Panorama Therapy or a trusted colleague we can refer you to.

At your first session, you’ll schedule a recurring appointment time with your new therapist. Most clients book weekly sessions, where you’ll see improvements and growth the most quickly. For therapy to be helpful, it’ll be important that you and your therapist have the chance to develop rapport and a good working relationship. It’s because of this that we recommend weekly sessions and advise against infrequent sessions, especially as you start out.

Outdoor scene with a stone path through a gate

Starting therapy can be a deeply relieving and hope-instilling process. Some clients may start to feel better after making an appointment or attending their first session, but this isn’t always the case. Therapy can be emotionally challenging because it requires us to take an honest and deep look at ourselves and our lives, and to make changes that may be difficult. This can be the case especially in the beginning.

Don’t let that discourage you. The short-term discomfort of therapy is outweighed by the long-term benefits. Successful therapy can lead to improved self-worth, relationships, and coping skills that can significantly enhance your quality of life. If all that was easy to achieve, with how hard you’ve tried, you probably would have mastered it by now!

Therapy isn’t an easy fix, but it is a worthwhile journey that can radically change your life. With the help of a licensed therapist like the psychologists at Panorama Therapy, you can gain the tools and insights you need to make positive changes and live a happier, more fulfilling life.

This is an excellent and hard-to-answer question! The length of therapy really varies depending on your specific needs, goals, and preferences. Some folks benefit from short-term therapy (e.g., 6-12 sessions), while others may prefer the rewards of longer-term therapy. In your first sessions, you’ll have the chance to discuss with your therapist what your customized therapeutic journey will look like.