Do you take insurance?

Two ways in. I see clients in-network through Alma for the plans Alma contracts with, where you pay your normal outpatient mental health copay and Alma handles the billing. Medicaid, Medicare, Fidelis and Healthfirst are not on the panel. If your plan is not one Alma contracts with, the practice is out-of-network at $225 per session, paid at time of service, with a monthly superbill you can submit to your plan for possible reimbursement if you have PPO out-of-network mental health benefits.

Where do I have to be located during a session?

Physically inside New York, Maine, Delaware, or Florida. Telehealth is regulated by the state where the client is sitting at the time of the session, not where the clinician sits, so this is a licensing rule rather than a preference. If you travel outside those four states, we schedule around it.

Is everything really online?

Yes. This is a telehealth-only practice — there is no physical office for sessions. Sessions run 50 minutes over secure, encrypted video on a HIPAA-eligible platform, or by phone if you prefer.

How often are sessions?

Weekly, with adults, individually. This is depth-oriented work rather than a short packaged program, and a consistent weekly hour is what makes it possible.

Telehealth · New York · Maine · Delaware · Florida

How it works

The practical mechanics, in one place: where you have to be sitting, what a session is, what it costs, and what happens on the first call. No part of this requires you to have decided anything yet.

The short version: Telehealth only, for adults, weekly, 50 minutes over secure video. You need to be physically located in New York, Maine, Delaware, or Florida during each session. There are two ways to pay: in-network through Alma for the plans Alma contracts with, or out-of-network at $225 per session with a monthly superbill. It starts with a free 30-minute call.

In crisis right now? Call or text 988 — this page can wait.

1. The first call is free, and it is a real conversation

Thirty minutes, by video or phone — your choice. No intake forms first, no fee, no commitment. The call exists to answer one question honestly: is this the right fit? You describe what is bringing you in, I tell you how I would actually work with it, and we cover the practical things — scheduling, cost, how insurance lands for your specific plan.

If I am not the right person, I will say so on that call and point you somewhere better. That is not a courtesy line; it is the first boundary you will watch me keep.

2. Sessions are telehealth only

There is no physical office for sessions. Everything happens over secure, encrypted video on a HIPAA-eligible platform, or by phone if that suits you better on a given week. Sessions run 50 minutes.

Telehealth is regulated by the state where you are sitting during the session, not where the clinician sits. So you need to be physically located in one of the four states below at the time of each appointment. This is a licensing rule, not a preference, and it is why travel sometimes means we reschedule.

3. Where you have to be

Matthew Sexton is a Licensed Clinical Social Worker in four states. Each has its own page with the detail for that state:

License numbers and registry entries are listed in full on the about page, including the NPI, which is public record.

4. What the work actually is

Adults, individually, weekly. Depth-oriented and pattern-focused rather than worksheet-driven — you talk, I talk back, and we work out loud on what followed you into the room. It is not a fixed-length program with a set number of modules, and it is not coaching.

Weekly consistency is what makes this kind of work possible, so that is the default rhythm rather than an upsell. Good therapy here is aimed at you needing it less over time.

The specialty pages describe the specific patterns this practice is built around:

5. Fees and insurance — two ways in

In-network through Alma. I see clients in-network through Alma for the plans Alma contracts with. On that route you pay whatever your plan charges for an outpatient mental health visit — the same copay you would pay any in-network therapist — and Alma handles the billing and the claims. Medicaid, Medicare, Fidelis and Healthfirst are not on the panel. Plan panels change, so my Alma profile always carries the current list rather than this page.

Out-of-network. If your plan is not one Alma contracts with, the practice is out-of-network at $225 per session, paid at time of service. After each month you receive a superbill — an itemized receipt with the codes your insurer needs — which you can submit to your plan for possible reimbursement if you have PPO out-of-network mental health benefits. What your plan reimburses is between you and your plan; the superbill is what makes the claim possible.

Whether either route works for your situation is one of the things the free call is for. If cost is a real barrier, you will hear that said plainly rather than discovered three sessions in. There is a full walk-through of how out-of-network reimbursement actually works if you want the mechanics before you call.

6. Your privacy, and what this website does not do

Sessions run on a HIPAA-eligible video platform. This website is a separate thing entirely: it holds no clinical records and no application database. The contact form relays your message straight to the practice inbox and stores nothing on this site. Analytics here are first-party and cookieless, and never record what you type. The full detail is on the privacy page.

Please keep clinical detail out of the contact form — a sentence about what is bringing you in is plenty, and the rest belongs in a session.

Frequently asked questions

Do you take insurance?
Two ways in. In-network through Alma for the plans Alma contracts with, where you pay your normal outpatient mental health copay and Alma handles the billing — Medicaid, Medicare, Fidelis and Healthfirst are not on the panel. Otherwise the practice is out-of-network at $225 per session with a monthly superbill you can submit for possible reimbursement if you have PPO out-of-network benefits.
Where do I have to be located during a session?
Physically inside New York, Maine, Delaware, or Florida. Telehealth is regulated by the state where the client is sitting, not where the clinician sits, so this is a licensing rule rather than a preference. If you travel outside those four states, we schedule around it.
Is everything really online?
Yes. This is a telehealth-only practice — there is no physical office for sessions. Sessions run 50 minutes over secure, encrypted video on a HIPAA-eligible platform, or by phone if you prefer.
What happens on the first call?
A free 30-minute call, by video or phone, with no forms first and no fee. It is for working out whether this is the right fit: what brings you in, how the work would go, and the practical questions about scheduling and cost. If it is not the right fit, you will hear that on the call along with a pointer somewhere better.
How often are sessions?
Weekly, with adults, individually. This is depth-oriented work rather than a short packaged program, and a consistent weekly hour is what makes it possible.
What if I need to cancel?
Scheduling and cancellation are covered directly on the free call, before anything is booked, so there are no surprises attached to the first appointment.

Still deciding? That is what the call is for.

Free, 30 minutes, no forms first — and if I'm not the right fit, I'll say so.

Start with a free 30-minute call

Rather write first? The form is just below. Rather talk now? (917) 432-9580.