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Again the agency has to eat the difference. Is this normal?

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Yes, this is not uncommon. If mental health providers sign on to be part of a health insurance plan's preferred provider group, they agree to charge less than their regular fee to patients/clients who have that plan. This is true for any health provider who is part of the plan, whether GP, surgeon, dentist, psychologist, etc. For example, my GP charges $190 for a physical exam if you don't have insurance, but only $140 if you have a certain plan, like I do. He has to "eat the difference" in cost and charge me less than his "true" fee. This is called the provider "write-off." Unfortunately, the person who doesn't have that insurance plan has to pay the full fee and "eat the difference" himself.

My first counselor charged me only $90 per session because she was a preferred provider. I don't know what her full rate was to people without the insurance plan. Of that, I only paid $9 per session for up to 20 sessions a year. It was great. Ahhhhh, those were the days. My current therapist charges me $125, and my insurance will not pay a penny of his fee. So I pay the full amount out of pocket. He's worth it, but I do have some frustration at the arbitrariness of who the insurance will reimburse for and who they won't. He is much better than my first counselor, but yet the insurance plan judges him less fit. They were both master's level therapists. I hate insurance. I guess, like ECHOES, though, I do see some advantage to not having my insurance be part of our interaction. I pay for therapy because I want it, it is very important to me, and no insurance company becomes apprised of my diagnosis or treatment details. I am also extremely motivated in therapy to make progress, perhaps in part because I pay so much of my own cool cash for my therapist's services. The clock is ticking each minute we are together; it is up to me to make sure I am getting my money's worth. I feel the responsibility and I do not dally in therapy or go in there and sit in the chair and say nothing.

My health plan considers psychiatric visits to be medical visits rather than mental health visits, and will pay for them at 90% for an unlimited number per year. Yes, I guess the insurance would rather that you took drugs than had therapy.

Another interesting tidbit is that my insurance will not pay for couples therapy or family therapy, only individual psychotherapy. I think they may pay for family therapy if the diagnosis involves addiction.