Sesame Care Review — Cash-Price Online Therapy, Psychiatry and Prescriptions

Overview

Sesame is a US healthcare marketplace. Instead of matching you with a clinician or billing your insurer, it lets you browse licensed providers, compare their upfront cash prices, reviews and open time slots, and book a video (or sometimes in-person) visit directly. For mental health, that covers talk therapy, couples therapy, psychiatry consults, and primary care visits for starting or refilling common psychiatric medications.

How it works

1. Choose a service — for example an online therapy session, a psychiatry consult or a prescription refill visit.
2. Pick a provider from the list for your state, comparing prices, reviews and availability. Same-day slots are often available.
3. Pay upfront and meet by video at the time you booked.
4. Pick up any prescription at a pharmacy of your choice. Medication is paid separately, and your pharmacy may run your insurance or a discount card for it.

Therapy on Sesame

Sesame lists online therapy sessions with licensed therapists, counselors and clinical social workers, plus online couples therapy sessions. Therapists may use approaches such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT). Therapy visits do not include medication.

Because you book session by session, there is no weekly subscription. The trade-off is that you manage your own rebooking. If you want a single matched therapist with messaging between sessions, compare BetterHelp.

Psychiatry and medication

For medication, you can book a psychiatry consult with a psychiatrist or psychiatric mental health nurse practitioner, or a mental health consult with a primary care provider. Sesame says a new-patient psychiatry visit includes a psychiatric evaluation and a treatment plan. It notes that psychiatrists are not available in every state; where they are not, primary care providers can manage certain mental health prescriptions after an evaluation.

Sesame lists these as commonly prescribed on its platform, at the provider’s discretion:

• Antidepressants such as sertraline, fluoxetine, escitalopram, bupropion and duloxetine
• Non-controlled anti-anxiety medications such as buspirone, hydroxyzine and propranolol
• Mood stabilizers such as lithium and lamotrigine, and antipsychotics such as aripiprazole
• Non-stimulant ADHD medications such as atomoxetine, viloxazine and guanfacine

Providers on Sesame do not prescribe controlled substances. That rules out ADHD stimulants (Adderall, Vyvanse, Ritalin, Concerta), benzodiazepines (Xanax, Ativan, Klonopin, Valium) and controlled sleep medications (zolpidem, eszopiclone, zaleplon). See our guides to ADHD medications and anti-anxiety medications for how these options compare.

Care by condition

Sesame has dedicated pages for common concerns, each showing providers and prices for that need:

• Anxiety treatment online
• Depression treatment online
• ADHD treatment online (non-stimulant)
• Insomnia treatment online

Pricing and the Mental Health Rx subscription

Every provider sets their own price, and you see it before you book. Sesame says mental health visits start as low as about $34, and that an online psychiatrist appointment costs about $132 for 45 minutes on average — as low as $37 in some states.

If you expect to need ongoing prescriptions, Sesame’s Mental Health Rx subscription costs $79 a month. Sesame says it includes same-day video visits with a provider you choose, unlimited messaging, and ongoing prescriptions and refills when clinically appropriate. Medication is paid separately.

Sesame does not bill insurance, but it accepts HSA and FSA payments. If you have strong in-network mental health coverage, a service that bills your plan — such as PlushCare — may cost you less per visit.

Provider credentials

Sesame says every provider must hold an active NPI number and a license in good standing that allows them to practice independently in each state where they are listed. Mental health providers include licensed therapists (such as LMFTs, LCSWs and LMHCs), psychologists, psychiatrists, psychiatric nurse practitioners and primary care clinicians. Check the credentials on each provider’s profile before you book.

Privacy

Sesame publishes its privacy policy and terms of service on its website, and processes payments through Stripe. Because you book individual clinicians through a marketplace, read the policy to understand how your information is shared with the provider you choose.

Customer support

Sesame offers help through its website and app. It is not an emergency service. If you are in crisis in the US, call or text 988 or call 911 — see Get Help Now.

Methodology

We checked Sesame’s mental health services, pricing, prescribing policy and provider requirements against its own website on September 26, 2026, and assessed it against each criterion in our review methodology. Prices are set by individual providers and change often, so confirm the price shown before you book.