Question 1

What does it cost to participate?

Accepted Answer

Joining Breakthrough is free, with no subscription or cut of your session fees. The only thing we charge therapists for is Care Start: help with scheduling, intake forms, coverage details and follow-up through the first weeks of care.

For each commercially insured or cash-pay client, Care Start is $30 per completed week, for up to four weeks.

Care Start is free for public-program clients, including QUEST, Medicare and TRICARE.

You or your practice pays the fee; clients never do. No fee unless a first therapy session is booked, and incomplete weeks aren’t billed.

Fees apply only to matches accepted on or after October 15, 2026. Nothing is billed retroactively.

Question 2

Who can join?

Accepted Answer

Independently licensed Hawaiʻi clinicians – LCSW, LMFT, LMHC, PhD/PsyD, and psychiatrists. If you hold a current Hawaiʻi license and run your own practice, solo or group, you're eligible. We verify every license with the Hawaiʻi DCCA before a profile goes live.

Question 3

Do I have to sign a contract?

Accepted Answer

Do I have to sign a contract?

Yes. Once our Therapist Agreement is available to sign in your portal, you must complete it before accepting new matches through Breakthrough.

There are two required parts, even if you only accept clients whose Care Start is free:

Participation terms: you sign these personally.
Client-information protections: your practice signs these. For a solo practice, that’s usually you.

Care Start fee terms are a separate, optional choice. You or your practice must accept them for commercially insured and cash-pay clients whose matches you accept on or after October 15, 2026. The payer must also have the required payment method on file before you accept a fee-eligible match. Without fee acceptance, you can still accept public-program clients at no charge.

Signing the required parts does not itself commit you to Care Start fees.

Question 4

I bill through a third-party platform like Headway or Rula. Can I still use Breakthrough?

Accepted Answer

Yes, many of our therapists do. Flag the platform in your intake and we’ll note it on your profile, so a matched client knows to set up an account there before booking. Your billing runs exactly as it does today.

Question 5

How many matches will I get?

Accepted Answer

No set number or quota. We match for fit, not even distribution, so volume varies. Your biggest lever is the payment you accept: the more plans you take, the more clients you can match with. (Demand is real: 415+ Hawaiʻi residents have completed intake since March 30.)

Question 6

How long do I have to review a match?

Accepted Answer

Five days. Review the anonymized intake summary and approve or pass on your own time – if a match goes five days without a response it expires, which counts as a pass and never affects your listing, your position in what a client sees, or your standing. The clock doesn’t run while you’re paused, on leave, or covered by another clinician.

Question 7

What if I pass on a match?

Accepted Answer

Nothing happens. The client never sees your profile, no explanation is needed, and passing doesn’t affect future matches.

Question 8

I approved a match. Now what?

Accepted Answer

Nothing left to do. Your profile goes to the client, who decides whether to request an intro. If they do, we connect you both by email, and you reach out to schedule a consult or first session. Heads up: you won’t see the client’s contact details until they request that intro, so an approved match with no contact info yet is normal, not a glitch.

Question 9

What happens while the client is deciding?

Accepted Answer

The client compares everyone who approved and chooses in their own time – there’s no set window, and not every client moves forward. Your portal shows the status of each match you’ve approved, so you always know where things stand without chasing anything.

Question 10

What if the client chooses a different therapist?

Accepted Answer

Then no introduction is made, and there’s nothing you need to do. Your profile only ever reaches clients you’ve already approved.

Question 11

Do I have to do a free consult?

Accepted Answer

No. You choose whether to offer a free 15-minute consult or start with a full therapy session. A consult can help you both check the fit, with no obligation to continue afterward. It is free for the client and never starts a Care Start billing window.

Question 12

How is my profile made, and can I edit it?

Accepted Answer

Your profile is generated automatically from your intake answers. We standardize it on purpose, so there’s no bio to write, and clients compare every therapist on the same factors rather than on writing skill. To make updates, log in at match.breakthrough.me with the email you used to sign up. The clinical-style scores aren’t directly editable, but if you think they’re off, email us and we’ll send a retest of that section.

Question 13

How does Care Start billing work?

Accepted Answer

Care Start fees appear on monthly statements, with a maximum of $120 for each Care Start. Only completed eligible weeks are billed; incomplete weeks cost $0.

The four-week billing window starts on the day the first therapy session is booked, or 14 days before its scheduled date if booked further out. The booking must be confirmed; confirming it is not itself a charge. Rescheduling before the first session takes place can move the window later. Eligible completed weeks can be billed even if no session takes place.

Care Start is free for clients covered by QUEST, Medicare, TRICARE or another public program listed in the Therapist Agreement’s Exhibit A-4, with no card required. Employer plans, including EUTF and FEHB, count as commercial coverage.

Whoever pays must have the required payment method on file before you accept a fee-eligible match. Signing the agreement or accepting the fee terms does not itself require a payment method or create a charge.

Questions therapists ask.

Still deciding?