Our Scoring Criteria for Online Therapy Platforms

Online therapy can be a convenient and cost-effective way to receive mental health services. Deciding which online therapy platform is the right fit for you can be an overwhelming task. ChoosingTherapy.com can help guide you in the right direction by providing in-depth, personally researched reviews, as well as multi-category ratings of the top online therapy platforms currently available. Our goal is to help consumers find the best online therapy service that matches both their expectations and desired therapy goals.

Before scoring an online therapy platform, we consider several significant factors. Below you’ll find a list of our online therapy platform scoring criteria, including how we define the key categories and features, what we look for when we rate them, and a breakdown of our star rating system.

Therapy Types & Clientele Served

Knowing what types of clientele an online platform serves allows clients to identify whether they are in the right place for treatment. Online therapy platforms that serve a full range of clientele, such as individuals, couples, teens, and more, are the ideal platform. Serving multiple clientele types gives clients the opportunity to attend multiple types of therapy (i.e. individual and couples/family therapy) on one platform, and to allow their family members, particularly children, also utilize one platform. This streamlines care and increases accessibility to services.

Please note: For platforms that specialize in a particular clientele (i.e., kids and teens or couples), we do not grade on this criteria. We instead grade on the clientele-specific criteria in the addenda below.

The most common therapy types an online therapy platform should offer are:

  • Individual Therapy
  • Couples Therapy
  • Kids (10+) and Teens (13+)
  • Family Therapy
  • Group Therapy or Support Groups

Star Ratings for Therapy Types

5-stars – The online therapy platform offers all of the most common types of therapy.

3-stars – The online therapy platform offers two or three types of therapy.

1-star – The online therapy platform only offers individual therapy.

Range of Therapist Specialties & Treatment Approaches

Offering a wide range of therapist specialties (i.e. treatment for anxiety, depression, etc) and treatment approaches (i.e. CBT, DBT, etc) means an online therapy platform can serve a wide range of clientele, with treatment options that are flexible and match their specific needs. This is important both for clients unsure of what type of therapy they are looking for or need, as well as for clients who are looking for a specific type of treatment for their given diagnosis.

During our review process, we examine the range of therapist specialties and treatment approaches offered on each online therapy platform. Platforms that offer a wide range of both will score the highest in this category. Additionally, therapist specialties and treatment approaches offered should be clearly listed in their profiles for clients to make informed decisions about their care.

Star Ratings for Specialties

5-stars – The online therapy platform offers a wide range of treatment approaches and therapist specialties, and they are clearly listed in therapist profiles. Treatment plans are clearly defined as an expectation by the platform.

3-stars – The online therapy platform offers only a limited range of treatment approaches and therapist specialties, however, they are clearly listed in their profiles. The platform indicates that treatment plan completion is left to the therapist’s discretion.

1-star – The online therapy platform is a specialized platform that offers one type of treatment approach and all therapists are specialists in this one treatment type. They may be subject to the additional grading criteria in the addendum below. Treatment plans are not clearly explained anywhere on the platform.

Geographic Location

One of the greatest barriers to those seeking online therapy is the availability of therapists licensed to provide services in their state. When reviewing online therapy platforms, one of the top five factors we look at is how widely available their services are across the United States. Platforms that are more widely available will score higher in this category, as they serve a larger percentage of the population and increase access to care. Platforms that are more widely available also make it easier to maintain care during a move, travel, or when frequently traveling between states for work or school.

Star Ratings for Location

5-stars – The online therapy platform is available nationwide OR covers 50% or more of the US population.

3-stars – The online therapy platform covers around 30% of the US population.

1-star  – The online therapy platform covers less than 10% of the US population.

Session Length & Provider Consistency

Patients should be aware ahead of time of the duration of each appointment, which should afford them ample time to share their current concerns and receive appropriate care. We look for platforms that offer therapy sessions at least 45 minutes long, potentially longer for first sessions.

Furthermore, ideal online therapy platforms will allow patients to see the same therapist for their entire duration using the platform. If their therapist leaves the platform, the client won’t have to completely “start over” with their new provider, as they will have access to notes, check-ins, and more to ensure continuity of care even if there’s a provider switch.

Scoring Breakdown for Session Length & Provider Consistency

5-stars – All therapy sessions are at least 45 minutes and the provider does a thorough overview of symptoms/concerns. It’s expected that you’ll see the same provider for every session. If the original provider is no longer available through the platform, clients don’t have to choose a new one on their own and it’s handled automatically—though if they want to swap that’s also easy to do. The new provider has access to all notes and the client won’t need to do another “intake” session.

3-stars – Therapy sessions are 30–45 minutes, and these may be video or phone calls. Clients do not consistently see the same provider, or have one provider for their initial assessment and another/other for follow-up appointments.

1-star – Therapy sessions are 30 minutes or shorter, with no way to request longer visits. It is unclear how often you are expected to attend sessions and whether you will meet with the same provider each time.

Ongoing Access to Your Provider

Having options for ways to attend appointments is important, as it greatly impacts your access to care. The best online therapy platforms will offer either video or phone sessions, and these should be easy to schedule within the app or online portal. Therapists should have enough availability to continue regularly seeing returning clients.

Ideal platforms will also feature an option for patients to send written messages to their therapist with any questions they have in between appointments. These messages should be sent from the platform’s app or website in a HIPAA-compliant manner, and responses should come within 24 hours.

Scoring Breakdown for Ongoing Access to Your Provider

5-stars – Upon signing up, clients can immediately access a messaging portal that they can use to chat with their therapist before their first appointment and between sessions. First meeting with the therapist should be over video or phone and easy to access through the app or through a link sent by text or email. Ongoing sessions should be easy to schedule as-needed either with the therapist at the end of a session or through an online booking portal.

3-stars – Therapy sessions are either over phone or video but getting to your appointment requires several steps. It’s possible to schedule follow-up appointments but there’s no way to make that an automatic, recurring event. There may or may not be regular check-ins as part of the care plan. There is an option to send in-app text messages and responses come within 48 hours.

1-star – Only one option for first sessions (either phone or video) and it’s difficult to access. No regular sessions scheduled or this is unclear. There is no option to contact your therapist between appointments.

Online Therapy Cost

The best online therapy platforms will be very clear and upfront about the expected costs for services. Whether it be a monthly subscription fee or per session cost, clients should know all expected costs prior to signing up for therapy. It should also be easy to understand how you will be charged, either through your credit card or FSA/HSA card, and when charges will occur. Monthly subscriptions should have no hidden in-app costs for extra features, like webinars, worksheets, or mindfulness exercises. Likewise, platforms that offer per-session rates should not have hidden fees, like monthly membership fees or sign-up fees.

Additionally, per-session costs should be in line with the type and length of service rendered, and it should be clear if costs are based on the provider’s level of education. Online therapy platforms offering per-session rates should be the same or less than what it would cost to see a provider in-person. Truly great online therapy platforms will also offer sliding scale fees and/or financial aid of some type to make services more accessible.

Star Ratings for Cost

5-stars – Monthly subscription costs are clearly provided prior to signing up and there are no additional hidden costs. Platforms that offer per-session rates are clear about rates up front, when payment is due, and whether the cost is based on the provider’s education level. There are no additional monthly membership fees or sign-up fees and per-session costs are in line with the type and length of service rendered. There are sliding scales or financial aid available to those who qualify.

3-stars – Monthly subscription costs can be difficult to find right away, but there are no additional hidden costs. Per session rates are clear and somewhat reflective of the type and length of service rendered. It is unclear if the per-session rates are based on the provider’s education level. If there are sliding scales or financial aid available, you have to ask about this prior to signing up.

1-star – Upfront monthly subscription costs are dependent on your location and are not provided until after you have completed the sign-up process. Per session rates are very unclear, session lengths are not reflected in the cost, and there is a monthly membership fee you must pay on top of therapy costs. There is no financial aid or sliding scale available to anyone.

Payment Options, Insurance, & Out-of-Network Benefits

Whether an online therapy platform accepts insurance will be a huge deciding factor for many seeking online therapy. When rating online therapy platforms, we go beyond looking into whether a platform accepts insurance to also look at how many insurance plans are accepted, and whether that acceptance is specific only to certain states. We also research whether the online therapy platform collects and determines client eligibility for using their insurance prior to an appointment or after, with ideal platforms completing this process before they see a therapist.

Additionally, we look at whether a platform assists clients in using out-of-network benefits. Companies that provide a more “white glove” service when it comes to paying by insurance or using out-of-network benefits, and that make the process as easy and understandable as possible will earn more points in this category. Platforms that accept HSA/FSA, offer sliding scale, or have other options for self-pay will earn higher scores as well.

Star Ratings for Payment Options

5-stars – Accepts insurance from many major insurance providers. The process for inputting insurance information is easy and there is a live person available if clients need help with this process. The client’s insurance is run prior to their live session with a provider and they know whether their insurance covers the service and what the out-of-pocket costs will be well in advance of a live session. If someone’s insurance plan isn’t accepted, it’s easy to request a superbill and/or use HSA or FSA for payment. If a company doesn’t accept insurance, they offer discounts, financial aid, sliding-scale or low-cost therapy, and make every effort to make therapy accessible for people of lower incomes.

3-stars – Accepts select major insurance providers or select insurance plans by state. The process for inputting your insurance is easy, but there is not a live person available to help you with the process. Insurance may be run prior to an appointment or afterward and out-of-pocket costs can come as a surprise. The platform will accept either HSA or FSA funds to pay for therapy OR they will create and submit a superbill for clients, but they will not allow both. If they don’t accept insurance, they make some effort to offer sliding-scale rates.

1-star – This platform does not accept insurance at all. The platform does not accept HSA funds or FSA cards to pay for therapy. They offer a superbill, but clients must submit it to their insurance company themselves to bill their out-of-network benefits. If insurance is not accepted, there is no effort to offer sliding-scale rates.

Therapist Matching or Selection

Options for choosing a therapist are integral to an online therapy platform experience. Some platforms approach this by providing matches and others allow clients to self-select.

For online therapy platforms that match clients with therapists, we look to see if the process includes talking with a live matching agent to curate hand-picked matches, or if an algorithm does the matching. Platforms that offer more support during the therapist matching or selection process will score higher than those that only use an algorithm to match clients with providers.

Furthermore, we look at how the platform’s online therapist directory works, whether it is accessible/searchable by clients, and if so, what filters you can use to find therapists. Directories that allow you to access and search their directory of therapists, as well as filter for gender, educational level, specialty, and cost will score better than those that offer only one or two filtering options, or that are not searchable by clients.

Star Ratings of Matching or Selection

5-stars – Clients can choose to have a matching agent help them select a therapist or they can choose one on their own. If clients choose their own therapist, the online therapist directory is easy to use and has filters for gender, educational level, specialty, and cost. The platform offers a wide range of therapist specialties and these are clearly listed on the website or in the therapist’s profile.

3-stars – Clients are left to select a therapist without any guidance. The online therapist directory is fairly easy to navigate, but may only have two or three filters available. The platform may only offer a few specialties and while these are listed on the website, it is vague which therapist offers which specialty.

1-star – Clients are automatically matched with a therapist through an algorithm and there is no therapist directory for them to browse. The platform offers one type of specialty, which is listed on the website, and all therapists on the platform are certified in only this specialty.

Client Interface & User Experience

When researching online therapy platforms, we look at how easy to navigate the main websites is, how user-friendly the sign-up process is, as well as how intuitive the mobile apps are that the company creates. Companies that have mobile apps will score higher in this area, as this allows clients the ability to more easily access live therapy sessions, client portals, and resources. It should also be made clear during the sign-up process whether clients need to download any additional apps, like Zoom or Google Meets, in order to attend a live session, or if they are accessible from the platforms’ software.

Star Ratings of Interface & Experience

5-stars – The online therapy platform has an app that is easy to use and intuitive. It is clear how clients need to attend live therapy sessions, either through their app or by downloading an additional app. The platform also sends you a link via email, text, or both, making it easy to join a session from your phone or laptop. The sign-up process is quick and easy.

3-stars – The online therapy platform has an app, but it is not clear during sign-up how you are supposed to attend live therapy sessions. The sign-up process is easy but may ask a lot of onboarding questions.

1-star  – The online therapy platform does not have an app and you must use a web browser to access your account. It is not clear during the sign-up process how you are supposed to attend live therapy sessions and navigating the website and signing up is confusing. The sign-up process was complicated and took longer than 10 minutes to answer all of the onboarding questions.

Privacy & HIPAA

Digital privacy, confidentiality, and HIPAA compliance are important to consider when choosing an online therapy platform. An ideal therapy platform keeps the client’s account information, such as credit card numbers, email addresses, diagnosis, or other identifying data, private and protected by legal standards at all times. When ranking for this category, our objective is to promote companies that have transparent and ethical privacy and HIPAA policies, as well as data-sharing practices, and who consistently meet client’s privacy and HIPAA expectations. Companies that are unclear about these policies and/or exhibit unethical actions regarding privacy, security, data sharing, or HIPAA will receive lower scores.

Star Ratings for Privacy & HIPAA

5-stars – Privacy and HIPAA policies are easy to find, clearly stated, and specific. The company is transparent about data-sharing practices and consistently meets client’s expectations. There are no reports of security issues, such as personal information or credit card information being stolen. Clients are prompted to sign a HIPAA agreement acknowledging they are on a HIPAA-compliant platform during the sign-up process, and all HIPAA policies are adhered to.

3-stars – Privacy and HIPAA policies, as well as data sharing practices, are difficult to find and/or generic and unspecific OR there have been some incidents of users facing security issues with private information. Clients are prompted to sign a HIPAA agreement only prior to their first therapy session, but it was not made clear during the sign-up process the platform uses HIPAA-compliant software.

1-star – The company has no stated privacy policy. There have been many reports of security issues with private user information. The company shares member account information without informing the user. Clients are never asked to sign a HIPAA agreement and it is unclear if the platform is actually using HIPAA-compliant software.

Therapist Credentials & Expertise

It is important to know exactly what credentials your therapist holds, specialty areas they treat, and if they are licensed in your state. Therapy platforms that make this information readily available are ideal as it gives clients crucial information immediately. In particular, licensure information informs clients whether a therapist can provide them services, as well as what licensing board they could report any issues with the therapist to. Additionally, knowing what mental health issues a therapist can treat helps clients to identify if they are in the right place for treatment.

Online therapy platforms that provide detailed profiles of their therapists, including information such as their education level, states licensed in, clientele served, years of experience, and specialty areas will rank higher than platforms that do not provide this information.

Star Ratings for Credibility & Expertise

5-stars –  It is clear what credentials the therapist has, what states they are licensed in, which clientele they specialize in treating, and how long they have been practicing. This information is readily available through the therapist’s profile, which the platform provides through its online therapist directory.

3-stars – It is clear what credentials the therapist has and which states they are licensed in, however, the therapist’s profile is missing other key information.

1-star – It is clear that the therapist has some type of credential, but it is not clear which states they are licensed in and there was no profile to read.

Customer Service

As with any service, the quality of an online therapy platform’s customer service is a significant rating factor. Online therapy platforms may be penalized in this category if it’s difficult to find customer support contact information or connect with a representative, or if it lacks channels of communication to contact support (e.g., only has email, no phone numbers listed).

We also take into consideration user reviews from trusted sources when scoring for customer service. We research and analyze positive and negative reviews that mention customer service and track when the company responds to complaints on trusted user review websites, as well as in the Apple App Store and Google Play Store when relevant. Companies that provide prompt and effective feedback and support will score higher in this category.

Star Ratings for Customer Service Category

5-stars – The platform offers excellent customer service. There are multiple channels to communicate with a representative, including email, text, chat, and phone. Responses to issues and complaints are completed within two business days. There are very few, if any, customer complaints in reviews online. When problems are reported in reviews online, the company responds efficiently and effectively.

3-stars – The platform provides an average level of customer service. There are limited channels to communicate with a representative. Response time takes more than 3 business days. The company will sometimes respond to issues reported in reviews online.

1-star – The platform provides poor customer service. You can only reach a representative through one channel. Response time takes over a week and many issues are left unresolved. The company does not respond to reported issues in reviews online.

Reliability & Longevity

Our reliability and longevity score will be determined by several key factors. These key factors include:

  • How long an online therapy platform has been in operation
  • How many therapists they have on the platform and how many states they serve
  • Which of the top insurance providers the platform works with
  • How much growth has the company experienced over the past three years
  • What additional services they offer
  • User reviews establishing a track record for meeting client’s needs and expectations

We want to direct users toward online therapy platforms that will continue to grow and won’t disappear or phase out after a user purchases a monthly subscription or signs up for sessions. It’s important to note that we also conduct updates to our online therapy reviews, so a newer platform may receive a higher score after it has proven its reliability and longevity over time.

Star Ratings for Reliability & Longevity Category

5-stars – The platform has been in operation for more than five years and serves 50% of the US population. The platform works with the top insurance companies in the states they provide care. The platform has grown over the past three years and offers additional services like teen therapy, couples/marriage counseling, and psychiatry. User reviews of the platform share very few complaints about the service and they consistently meet or exceed the client’s needs and expectations.

3-stars – The platform has been in operation for three years and can serve 30% of the US population. There are only a few major insurance companies the platform accepts and they have been working with them less than three years. The platform is still growing and only offers one additional service, like marriage counseling. User reviews mention some complaints about the service and clients’ needs and expectations are sometimes met.

1-star – The platform is brand new and has been active for one year and serves 10% of the US population. They do not work with any insurance companies and offer only individual therapy. Complaints or compliments are hard to find, as there are few to little user reviews.

Addenda

There are online therapy platforms that specialize in offering therapy to kids and teens only, or marriage and couples counseling only. In addition to the scoring rubric above, there is a clientele-specific category we score on for each of these types of specialized platforms.

Online Therapy for Kids & Teens Scoring Features

Platforms that specialize in offering online therapy to kids and teens should give parents/guardians clear answers to their questions and concerns prior to signing up.

Ideal kids & teens platforms will:

  • Explain which age groups are served.
  • Have clear language around how accounts are used and managed.
  • State what the role of the parent/guardian will be during live sessions.
  • Offer evening/weekend appointments.
  • Have specialized treatment plans geared towards teens.
  • Feature extra in-app or online resources the minor client can access without adult supervision.

Furthermore, the therapist should check-in with the parent/guardian at least once a month to discuss progress being made or lack of progress being made.

Star Ratings for Kids & Teens

5-stars – The online teen platform clearly explains which age groups are served, how accounts are used and managed, what the role of the parent/guardian is during live sessions, offers evening/weekend appointments, has specialized treatment plans, and offers extra resources the kid/teen can access without parental supervision. Therapists check-in with parents/guardians at least once a month to discuss progress.

3-stars – The online teen platform clearly explains which age groups are served, how accounts are used and managed, and offers evening/weekend appointments. It is not clear what the role of the parent/guardian will be during live sessions and there are no specialized treatment plans. Extra resources are limited but can be found either in the app OR on the website. Therapists check-in with parents/guardians every couple of months.

1-star – The online teen platform clearly explains which age groups are served and how accounts are used and managed. It is unclear if there are evening/weekend appointments available or what the role of the parent/guardian will be during live sessions, and there are no indications if the platform offers any specialized treatment plans or extra resources. Therapists do not check-in with parents/guardians but will give updates if asked.

Online Marriage & Couples Counseling Scoring Features

Platforms that specialize in offering online counseling for couples should give clear answers to any questions and concerns prior to signing up. The ideal platform will explain how the sign-up process works and at what point is the partner added to the main account. These platforms will allow couples to have their own logins and extra resources the other person does not have access to. Couples will be able to attend live therapy sessions in a three-way call if needed and not have to be in the same room at the same time. If there is an option to meet one-on-one with the therapist, it should be clear if this is an additional cost.

Star Ratings for Marriage & Couples

5-stars – The platform clearly explains how the sign-up process works and at what point a partner is added to the main account. Couples have their own logins and access to extras resources the other person cannot see. Live therapy sessions can be a three-way call if needed and if there is an option to meet one-on-one with the therapist, it is clear if this is an additional cost.

3-stars – The platform clearly explains how the sign-up process works and at what point a partner is added to the main account. Couples have their own logins and access to extras resources the other person cannot see. Couples have to be in the same room in order to have a live therapy session and there are one-on-one sessions available for an extra cost.

1-star -The platform clearly explains how the sign-up process works and at what point a partner is added to the main account. It is unclear if couples have their own logins and access to extras resources the other person cannot see. Couples have to be in the same room in order to have a live therapy session and there are no one-on-one sessions available.

Specialty Services

Some online therapy platforms are designed to only treat certain conditions, such as OCD, PTSD, ADHD, etc. These platforms should not be penalized for not offering a “wide range of therapy modalities,” as many specific concerns also have specific treatment plans that work best. This addendum will take the place of two categories on our main scoring criteria, “Clientele Served” and “Range of Therapist Specialties & Treatment Approaches.”

Star Ratings for Specialty Services

5-Stars – This is a specialized platform that offers a combination of evidence-based, specialty-specific treatment options, including online therapy and options for medication management. All therapy sessions will happen with the same providers each time, unless a change is requested by the client. Weekend and evening appointments are available. All appointments and sessions take place in the platform’s app or on their website, with no need to download additional applications. Evidence-based, specialty-specific education or exercises should also be offered.

3-Stars – This is a specialized platform that offers either evidence-based online therapy or medication management for the specialty-specific concern. If providing medication services, there is clear language around what medications can be prescribed, but there is no option to coordinate with the primary care provider if needed. There are inconsistencies in providers across sessions and session times. There are no or limited weekend and evening appointments and you must download a secondary application to attend video sessions.

1-Star – This is a specialized platform that offers either online therapy or medication management for the specific concern, but it is unclear whether it is evidence-based. There is no clear language around what types of medications are prescribed, there is no coordination with primary care providers, and it is unclear if you will have the same provider each time you attend an appointment or session. There are no evening or weekend appointments, and session lengths are short or unclear.

Star Ratings for Specialty Service If Medications Are Offered

5-Stars – There is clear language around what types of medications are prescribed and there is an option to coordinate with a patient’s primary care provider if needed. All medication appointments will happen with the same providers each time, unless a change is requested by the client. Initial appointment should be 45-minutes or longer, with medication follow-up appointments lasting 15 minutes or longer. Weekend and evening appointments are available. All appointments and sessions take place in the platform’s app or on their website, with no need to download additional applications.

3-Stars – It is listed that medication may be part of treatment, but it’s unclear who the prescribers are, first appointments are shorter than 45 minutes (or it’s unclear), weekend/evening appointments not available. May or may not coordinate care with primary care provider.

1-Star – It is listed that medication may be part of treatment, but all other details are unclear.

For more information, check out or editorial policies and our advertising policies.

This content was last updated 10/03/2025 by the Choosing Therapy team.

Here’s what we changed and why:

Split Up “Attending Live Video Sessions” Into Two Categories: “Session Length & Provider Consistency” & “Ongoing Access to Your Provider”

The “Attending Live Video Sessions” category of our scoring criteria was pulling a lot of weight, covering session length, formats for appointments, how easy it is to get into a session, scheduling follow-ups, and more. We decided that this category would better serve consumers if we divided it into two separate criteria, one dedicated to accessing your provider (messaging between sessions, scheduling future sessions, ease of joining sessions) and one focused on length and consistency (sessions should be at least 45 minutes, you’ll see the same provider every session, if they leave it won’t feel like “starting over” with someone new).

We feel this gives more balance and weight to what really matters most when using an online therapy platform: your actual experience when getting care from the comfort of your home, and how easy it is to continue with that care team.

Updated “Insurance & Out-of-Network Benefits” to include “Payment Options”

The highest-rated online therapy platforms typically accept a wide range of insurance plans. Others may not accept insurance, but make care easier to afford with flexible payment options and discounts. We wanted to make sure these companies aren’t penalized, so we added a caveat that, if a platform doesn’t accept insurance, they offer sliding-scale rates and accessible payment plans.

Removed “Extra Features & Resources”

Many online therapy platforms offer several “extras,” like a journaling space, video lessons, or other ways to encourage people to continue checking in on their mental health when they’re not in session. While these resources can be helpful for many, we felt it was unfair to penalize excellent online therapy platforms just because they don’t offer these bells and whistles. Instead of giving these extras their own section on our scoring criteria, we’ll call them out as “pros” on our pros & cons lists, and write about our experience with them in the body of our reviews.