SE, both of my therapists have said that they would cut me a check if I ended up overpaying them. (I usually hit my out-of-pocket max at some point in the year, so they may end up collecting more co-payments than necessary by the time the 100% payments from insurance start to come in.) And this would usually be on the scale of a hundred bucks or less. It seems very odd to me that your T won't do the same, especially if you need the money.