Octave is an online mental health practice offering individual, teen, couples, and family therapy services. It earned 3 out of 5 stars overall during our independent review process. Octave provides live video, phone, and texting sessions. While Octave isn’t available nationwide, it accepts many insurance plans making it a good option for many.
Octave at a Glance
Cost: Varies based on provider
Insurance Accepted: Yes
Pros & Cons of Octave
Pros - Individual, family, and couples counseling
- A wide range of experienced providers
- Offers an inclusive and supportive environment
- Over 50% of Octave therapists identify as BIPOC
Cons - Not available in all states
- Cash-pay rates are high compared to many competitors
- Provider selection is done for you; you can request a provider but it’s not guaranteed
- Monthly price is not determined until after you are matched with a provider
- Limited user reviews available online
Preview Octave
Octave is an online mental health platform that offers evidence-based therapy services to individuals, couples, teens, and families. It offers pay-per-session options, with various plans offering different support levels, including video, phone, and live-texting appointments. Its services are available to clients ages 18+.
If you’re looking for other counseling options covered by insurance, Talkspace could be a good option. Meanwhile, those looking for individual therapy on a cash-pay subscription basis might be well served by BetterHelp. Or, if you’re looking for psychiatry and therapy bundled together, Brightside Health could be your best bet.
Brightside - Therapy & Medication Using Your Insurance
Together, medication and therapy can help you feel like yourself, faster. Brightside Health develops personalized plans that are unique to you and offers 1 on 1 support from start to finish. United Healthcare, Anthem, Cigna, and Aetna insurance are accepted.
Detailed Octave Review
Octave is a mental health practice that offers evidence-based therapy services to individuals, couples, and families. It provides various treatment plans tailored to the specific needs of their clients. Octave is in network with many insurance plans, with cash-pay rates costing $170–$275 per session, and its services are available to clients ages 18+.
Review our scoring criteria for online therapy platforms here.
Review our complete editorial policies here.
Individual Therapy
Octave offers flexibility in scheduling therapy sessions, including evening and weekend appointments, to accommodate individuals’ busy schedules. This ensures that therapy can be attended at convenient times for most individuals.
Live therapy sessions with Octave typically last around 45 minutes, but this can vary based on your provider and your treatment plan. The frequency of sessions varies based on individual needs and therapy goals, with many users attending sessions weekly or bi-weekly.
Octave therapists may assign additional exercises or practices to support the therapy process. These could include journaling, reflection exercises, or guided activities through the Octave app.
Octave Couples Therapy
Couples typically undergo a similar intake process as individuals seeking therapy through Octave. It is common for couples to have a shared account where both partners can access and communicate with the therapist. However, partners can also message the therapist independently, facilitating open and individualized communication between all parties involved.
In addition to therapy sessions, Octave provides additional resources for couples, including articles, activities, and exercises to support relationship growth and communication.
The cost for couples therapy with Octave may vary depending on the specifics of insurance, but the cost is listed as $190–$275 cash pay per session.
Family Therapy
Octave offers family therapy to help address and improve familial relationships and dynamics. Anyone within a family system can initiate the sign-up process for family therapy. This could be a parent, guardian, or any other family member who recognizes the need for support and seeks assistance in fostering healthier family dynamics.
However, Octave does not see clients under the age of 18 (even for family therapy), so it can limit some families from accessing treatment.
Octave Cost & Insurance
Octave costs $170–$275 per session for cash-pay users. It notes on its website that 96% of users were able to receive coverage from their insurance provider, with the average copay being around $28, but the specifics will be determined by your insurance plan.
Octave is currently affiliated with Aetna, Anthem, Blue Cross/Blue Shield (in certain states), Cigna, Health Net, MHN, and United HealthCare, among other major and regional insurance providers. You can use the cost estimator to see what your state covers within those providers. Knowing your insurance coverage before enrolling is important so you have an accurate idea of your costs.
Here are Octave’s cash-pay prices:
- Individual therapy: $170–$250 per session
- Couples or family therapy: $190–$275 per session
Although Octave does not submit for reimbursement to out-of-network insurance companies, it will provide a superbill for clients with an insurance plan that isn’t supported.
Who Does Octave Serve?
Octave is available in 22 US states and Washington, D.C. so far, and does not offer services internationally. The company specifically serves adults 18+ who are struggling with mild-to-moderate mental health symptoms. Octave does not offer therapy for children or teens, and psychiatry (medication management) isn’t available on the platform, either.
Octave serves 22 US states plus D.C.: Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Maryland, Massachusetts, Minnesota, New Jersey, New York, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington state, Washington D.C., Wisconsin.
User Reviews
User reviews for Octave seem to have the consensus that the platform offers good care, but unexpected charges and other billing issues made the experience difficult for some. We were only able to find a handful of reviews for Octave from any given source, so it’s important to remember that they may not be representative of every user experience.
Reviews from Trustpilot | 3 out of 5 stars | 9 reviews
Positive reviews from Trustpilot include a user who was very satisfied with his therapist and even mentions that he could not have improved mentally as much as he had without her.
Negative reviews from Trustpilot include reports of problems with billing and insurance issues. Due to the limited number of reviews, it’s difficult to say if these are isolated incidents.
Reviews from Yelp | 2.3 out of 5 stars | 27 reviews
Positive reviews from Yelp about Octave indicated that users felt the platform enabled them to get help from highly skilled therapists.
Negative reviews from Yelp indicated that users tended to experience billing issues such as unexpected charges. Others felt they should have been able to consult with a given therapist prior to paying a full session fee.
Alternatives & Competitors
Octave operates on a pay-per-session basis and accepts many insurance plans. BetterHelp might be a better option if you don’t have insurance; its cash-pay prices are more affordable than Octave, but it doesn’t offer family therapy. Talkspace accepts many insurance plans, so if you’re not in-network with Octave, you should check Talkspace. It’s also a better option if you need mental health medication in addition to therapy.
BetterHelp - Best for Cash Pay
- Price: $280–$400 monthly
- Insurance Accepted: No
Both Octave and BetterHelp offer online therapy services, providing people with the convenience of accessing mental health support from their own homes. Users can connect with licensed therapists through messaging, live chats, and video sessions.
Key differences between Octave and BetterHelp include:
- Octave offers therapy for individuals, couples, and families. BetterHelp offers therapy to individuals, couples (through its subsidiary Regain), and teens 13+ (through Teen Counseling), but not family therapy.
- Octave assigns you a Care Navigator to help navigate the onboarding process whereas BetterHelp is mostly self-serve.
- Octave accepts several insurance plans, whereas BetterHelp doesn’t accept insurance at all. BetterHelp does offer a financial assistance program.
- BetterHelp offers extras like a journaling space, weekly workshops, and more, offering a “one-stop-shop” mental health app.
- BetterHelp’s cash-pay rates are more affordable at $280–$400 monthly ($70–$100 per week) whereas Octave’s cash-pay rates are $170–$275 per session, depending on the service.
To learn more about whether BetterHelp or Octave is best for you, read our detailed review of BetterHelp.
Pros & Cons
Pros - 30k+ therapists available
- Same-day appointments available
Cons - Does not accept insurance
- Limited choice over initial therapist
Talkspace - Best for Therapy + Medication
- Price: $276–$436 monthly
- Insurance Accepted: Yes
Both Octave and Talkspace provide the opportunity to connect with licensed therapists through secure messaging, live chats, and video sessions. However, there are some differences between the two platforms:
- Octave offers individual, couples, and family therapy. Talkspace offers individual and couples therapy, but not family therapy. Talkspace also offers medication management where Octave does not.
- Talkspace serves teens (13+) in addition to adults, whereas Octave only serves adults 18+.
- Talkspace accepts more insurance plans than Octave does, including some Medicare plans.
- Talkspace’s cash-pay prices are slightly more affordable than Octave, coming in at an average of $99 per session compared to Octave’s $170–$275 per session. However, Talkspace’s cash-pay is done on a monthly subscription plan rather than session-to-session.
You can learn more about whether Talkspace is a good choice for you by reading our comprehensive review of Talkspace.
Pros & Cons
Pros - Many major health insurance plans are accepted
- Psychiatry and teen (13+) therapy available
Cons - Exact monthly costs vary
- Limited ability to choose your therapist
Why You Can Trust My Review
“Overall, Octave appears to be a promising mental health startup that aims to provide accessible and comprehensive care through its therapy services. With a focus on affordability and inclusivity, Octave states it strives to make individual mental health support more attainable. While there may be some limitations, such as geographical availability, affordability, age, and fewer user reviews, Octave’s commitment to transparency and its experienced team of providers instill confidence in its ability to deliver on its promise of helping individuals navigate their mental health challenges.”
History & News About Octave
Company: Octave
Year Founded: 2018
Founders: Sandeep Acharya, MBA & Eric Gullichsen, MBA
Publicly Traded? No
Headquarters: San Francisco, CA
Octave was founded in 2018 by Sandeep Acharya, MBA, and Eric Gullichsen, MBA, with the mission to transform mental health care by making it more accessible and sustainable for both clients and providers. Since opening its first clinic in New York’s Bryant Park, Octave has expanded rapidly, now offering in-person and virtual therapy, including individual, couples, and family therapy, across 22 states and D.C. as of spring 2025.1 The company’s growth has been driven by a value-based, outcomes-focused approach, with clients experiencing up to 40% greater improvement in depression symptoms compared to industry averages and significantly lower attrition rates.2
Octave is in-network with major national insurers such as Aetna, Anthem Blue Cross, and Cigna, as a way to make in-network therapy affordable and accessible.3 The company has raised $86 million in venture funding, including a $52 million Series C round in 2023, to support its national expansion and technology development.4
Frequently Asked Questions
What Credentials Do Octave Therapists Hold?
Octave therapists undergo a vetting process to ensure they meet the necessary credentials and qualifications. They hold licenses such as Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), or Licensed Professional Counselor (LPC). In addition to their licenses, Octave therapists possess specialized training and experience in various areas of mental health. They bring a wide range of specialties and backgrounds to the table, ensuring that clients receive individualized and expert care.
How Am I Matched With a Therapist on Octave?
After filling out the initial forms and information questionnaire, Octave specialists will match you with a therapist.
Can I Choose a New Therapist?
If you are interested in changing your therapist, you can email the support email ([email protected]). You can search through providers available in your area and request a specific provider, but due to availability, it is not guaranteed.
How Do I Cancel My Subscription/Account with Octave?
Octave does not have a subscription, but you can cancel your account login anytime by contacting Octave customer support.
Does Octave Offer Refunds?
If you are unhappy with your service you can email [email protected] but all fees are nonrefundable.
Is Octave HIPAA Compliant?
Octave is HIPAA compliant and has a variety of privacy features. To learn more, you can read Octave’s privacy policy and Octave’s terms of service.
ChoosingTherapy.com strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.
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Team Octave. (January 13, 2025). Octave to Expand Premium Mental Health Care to Six States. Retrieved from: https://blog.findoctave.com/blog/octave-to-expand-premium-mental-health-care-to-six-states
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Octave. (2025). In-Person Therapy. Retrieved from: https://www.findoctave.com/in-person-therapy
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Octave. (2025). Learn How Insurance Helps Cover Therapy With Octave. Retrieved from: https://www.findoctave.com/insurance
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PR Newswire. (June 15, 2023). Octave Raises $52M in Series C Funding to Expand In-Network Mental Health. Retrieved from: https://www.prnewswire.com/news-releases/octave-raises-52m-in-series-c-funding-to-expand-in-network-mental-health-301851235.html
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Octave. (2025). Do you have questions about Octave? Retrieved from: https://www.findoctave.com/faq
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Octave. (2025). Our approach to Care. Retrieved from: https://www.findoctave.com/our-approach-to-therapy
We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: Alexa Donnelly, LCSW (No change)
Medical Reviewer: Kristen Fuller, MD (No change)
Primary Changes: Added new information to the “History & News” section; updated the map and the “Who Does Octave Serve” section with 8 additional states added since our last update; fact-checked and edited for readability and clarity.
Author: Alexa Donnelly, LCSW (No change)
Medical Reviewer: Kristen Fuller, MD (No change)
Primary Changes: Reviewed entire article and revised where necessary to ensure factual accuracy, clarity, and enhanced readability. Updated cash-pay pricing from $36 – $190 per session to $170 – $275. Reformatted whole article to new style.
Author: Alexa Donnelly, LCSW (No change)
Medical Reviewer: Kristen Fuller, MD (No change)
Primary Changes: Updated service area for Octave to include 17 US states. Added list of states serviced in “What Is Octave?” section. Added geographic coverage area to “FAQ” section. Updated FAQ section to new format.
Author: Alexa Donnelly, LCSW (No change)
Medical Reviewer: Kristen Fuller, MD (No change)
Primary Changes: Added review summary and features.
Author: Alexa Donnelly, LCSW
Medical Reviewer: Kristen Fuller, MD
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