With the insurance plans we've had they won't cover w/out a diagnosis. Previous ones you could pay out of pocket but it depends on the provider, some won't do that (and it's very expensive, at least where we have lived $125-$150 per hour range.
My first experience with DD when she was in K, the counselor (who was supposed to be really good for gifted kids) was very...casual...saying she needed to code either anxiety (a "lighter" diagnosis to attach to the child's record) or depression. She said she usually recommended depression,even if the child wasn't clinically depressed, because looking down the road, with this on the child's record it was easier to go on disability when the child turned 18.
That didn't set too well with me, a child with obvious problems at school but none at home. It was simply my opinion but it felt too much like throwing in the towel too soon without exploring anything else, a better school fit etc. Anyway I did thanks but no thanks to that.
With homeschooling there weren't any issues.
We explored it this summer after 2nd grade, having been back in school, and some bullying issues but just got some advice which when applied seemed to work wonders, then a great summer vacation. No diagnosis. I'm not looking deeper right now until we do some more educational type testing. My DD is staying afloat besides just being very tired, possibly according to her OT from the amount of compenstations she's doing for 2E type issues. We need more info about that right now it's the priority to get the whole picture/framework to move forward.
So I'd ask outright about how the diagnosis works, and maybe ask about family counseling? Maybe she's really holding it together at school but letting things come out at home where it's more "safe" to do so and you could learn some ways to help and feel more secure about your support to your DD.
It's all a very personal decision but you're right to seek as much info as you can! Anyway good luck.
