Here’s what a user signing up for Cerebral can expect: Depending on the plan they select, a user’s care team may consist of:
Care coordinators who can help with account management, provider matching, and monitoring messages to get responses to user questions from providers as necessaryPrescribers, such as psychiatrists, physicians, physician assistants, and nurse practitioners who assess, diagnose, and treat mental health conditionsLicensed therapists who provide therapy through the platformCare counselors who hold a master’s or bachelor’s degree in social work, psychology, or counseling and serve as a point of contact for patients; care counselors are not licensed therapists and cannot diagnose or treat mental health conditions
Users can change their prescribers or therapists at any time by contacting their care coordinator. Although the website states that users can chat with their prescribers and therapists through the platform, users don’t communicate with them directly, according to a Cerebral customer service call on October 5, 2022. Care coordinators monitor the patient portal chat and can pull in providers for responses as needed. You can cancel your subscription through the app or account settings anytime, or by notifying your care coordinator. The Medication Plus Care Management and Medication Plus Therapy plans include an initial evaluation and regular follow-ups with a prescriber, one monthly session with a care counselor, and unlimited messaging with your care coordinator. Initial sessions with prescribers are 30 minutes long, and follow-up visits last 15 minutes each, as per a customer service call with Cerebral on October 6, 2022. Sessions with care counselors are also 30 minutes long. Medication delivery is included in your plan if you choose to fill your prescription with Cerebral. Cerebral has prescribers licensed in all 50 states and Washington, DC, but plans that include online therapy are available only in states with licensed therapists. As of this writing, those states are Alabama, Arizona, Arkansas, California, Florida, Georgia, Hawaii, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. Cerebral offers a Medication-Assisted Treatment Plus Care Counseling plan for individuals managing opioid use disorder and living in Colorado, Florida, or Washington. This plan pairs you with a prescriber and a care counselor. The prescriber is a substance abuse specialist who meets with you as often as your treatment plan dictates. The care counselor meets with you monthly to support you and provide coping strategies to help manage your mental health symptoms. With this plan, medication delivery is not an option, and you will have to pick up prescriptions from your local pharmacy.
Compare Cerebral Plans
- Plan not mentioned on the Cerebral website Although not mentioned on its website, a customer service call with Cerebral on October 5, 2022, informed us that the platform also offers a Medication Plus Coaching plan that is similar to the Medication Plus Therapy plan. The difference is that it includes four 30-minute monthly live sessions with a care counselor rather than a therapist. Users can select only from the Therapy, Medication Plus Therapy, and Medication Plus Care Management plans when signing up for a plan. When asked about how to sign up for the other programs Cerebral offers, a Cerebral customer service representative advised on October 6, 2022, that users would have to call in to get their plan adjusted.
Therapy $259 per monthMedication Plus Therapy $325 per monthMedication Plus Care Management $99 per monthMedication-Assisted Therapy Plus Care Counseling $195 per monthMedication Plus Coaching $195 per month
If you prefer or need more than four sessions with your therapist or care counselor, you can pay $65 per session with a therapist and $30 per session with a care counselor, as per a conversation with a Cerebral customer service representative on October 5, 2022. The Medication Plus Therapy plan includes the cost of delivery but not the cost of the medication itself. Cerebral can bill your insurance for any covered medications you’re prescribed, and you would be responsible for the copay. If you’re paying for medications out of pocket, most cost $10, but some can go up to $40, per a call with the company’s customer service representatives on October 5, 2022. You can use your flexible spending account (FSA) or health savings account (HSA) card as a payment method, but only if you are paying for your subscription out of pocket. If your providers are in-network with your insurance, Cerebral can bill your insurance provider for your sessions. In this case, you will be responsible for a $30 monthly subscription fee, which is not covered by insurance, as well as your plan’s copay amount. Cerebral can provide superbills or invoices for those using out-of-network insurance benefits. When you’re signing up for the service, Cerebral warns via its terms and conditions that there are no refunds for partial subscriptions, even if users don’t end up seeing a provider. Cerebral does not currently offer financial assistance for its subscription plans. $125 per follow-up visit $108 per follow-up visit † Cost may be higher based on your preferences, location, and therapy availability. Positive reviews were from users who had a good experience with the care they received and who enjoyed the convenience of receiving care from their homes. Negative reviews mentioned unexpected charges and low provider availability. Users who used their insurance to pay noticed billing entries for more visits than they attended. Reviews also cited poor communication about changes to charges, such as when starting a new medication. Furthermore, reviewers described being charged even after they opted to cancel their accounts through the platform.
Cerebral in the News
In March 2022, articles from Bloomberg and the Wall Street Journal featured testimonials from former employees and users who were concerned about the safety of prescribing practices at Cerebral. Clinical and nonclinical employees raised concerns about the brief, 30-minute virtual visits with prescribers and internal company communications that encouraged prescribers to overprescribe medication. According to Jason Herrick, MD, the director of psychiatry for the Pediatric Behavioral Health Integration Program at Montefiore Medical Group in Bronx, New York, “Gathering all relevant information in a short period of time can be challenging. Less than 30 minutes for an initial assessment or making a diagnosis and treatment recommendations solely based on a questionnaire should raise concerns.” Psychiatric practice guidelines from the American Psychiatric Association (APA) advise that a provider can “use their clinical judgment to tailor their psychiatric evaluation” to the patient’s needs, but there are often barriers to properly assessing some conditions like substance use and suicidality in one visit. Prescribing and filling prescriptions for medications considered controlled substances are regulated by the Controlled Substances Act. Controlled medications require more safety precautions from the prescriber, pharmacy, and patient because of the potential for abuse or forming addictions. In response to the COVID-19 pandemic in March 2020, the Drug Enforcement Administration (PDF) updated the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which required prescribers to evaluate patients in person at least once every 24 months before prescribing a controlled substance. The update removed the in-person evaluation requirement and allowed telepsychiatry providers like Cerebral to prescribe controlled substances through its platform at the time. In May 2022, prosecutors with the U.S. Attorney’s Office for the Eastern District of New York served Cerebral with a grand jury subpoena relating to an investigation into possible violations of the Controlled Substances Act, according to the American Bar Association. Shortly after, Cerebral stopped prescribing controlled substances, but the terms and conditions still outline the user’s agreement if they are prescribed a controlled substance. In June 2022, a Wall Street Journal article stated that the Federal Trade Commission (FTC) had started investigating Cerebral for “deceptive or unfair practices related to advertising or marketing.” Similar to third-party reviews we’ve read, the article describes how users found it difficult to cancel their subscriptions. Documents obtained by the Wall Street Journal stated the FTC’s intention to investigate instances when Cerebral “continued to bill customers a subscription fee until the customer cancels.” On a call with Cerebral on October 5, 2022, a customer service agent informed us that a subscription fee will be charged on the day new users sign up and monthly on that day going forward. The agent also informed us that the subscription will be charged regardless of whether users attended an appointment with a provider or not. On the checkout page and in the Cerebral terms and conditions, the platform warns that there will be no refunds issued to users regardless of any services rendered by Cerebral. But, on a following call with Cerebral customer service a day later, the agent informed us that a refund can be possible if a user decides to cancel their subscription before they utilize any of the services on the platform. In September 2022, the Wall Street Journal published an article about Cerebral treating an underaged teen without parental consent and the subsequent death of the teen, which was ruled as a suicide. Unless they specifically offer teen therapy, most online therapy platforms, including Cerebral, do not treat individuals younger than 18. Treating teens and children who are younger than 18 online requires parental consent in most states. According to the article, the teen had disclosed a previous suicide attempt to his Cerebral provider. The platform stated that it treats suicidal patients and has a “specialized crisis response team” for patients who are actively suicidal. Online therapy is not appropriate for certain cases of severe mental illness, such as suicidal ideation or severe depression; in-person evaluation and treatment is more appropriate. We did not receive a response when we reached out to Cerebral to learn more about its prescribing and user-safety processes.
Our Experience With Cerebral
In our April 2022 survey of 1,000 online therapy users, 49 percent of Cerebral users indicated that they chose to use the platform because it had positive reviews online, and 42 percent of users indicated that they started using the platform because its plans were in their budget. Also, 67 percent of Cerebral users we surveyed agreed that they were satisfied with the care they received on the platform.
Engaged in ongoing independent researchMystery-shopped each of the brandsContacted brands’ customer service teams to ask questions and gauge responsivenessConsulted six leading psychologists and psychiatristsBecame customers of online therapy providers ourselvesReviewed academic research about the efficacy of online therapy versus in-person therapyRead hundreds of verified customer reviews from trusted third parties, such as the BBB and Trustpilot
Although some third-party reviews and Cerebral users we surveyed had positive experiences with their care on the platform, it has experienced scrutiny for unsafe prescribing and deceptive billing practices. You can also reach out to the SAMHSA National Helpline at 800-662-HELP (4357). The SAMHSA help line is a free, confidential, 24/7, 365-days-a-year treatment referral and information service for individuals facing mental or substance abuse disorders.
