Insurance Filing Instructions.
Because I am not on insurance panels I am considered by your insurance company to be an “out-of-network provider”. Most insurance companies will reimburse you for my services at a lower rate than if I were in-network. If you wish to use your insurance, I encourage you to call your insurance to understand exactly what your Mental Health out-of-network benefits are. When getting this information, the following specific questions should be asked:
- Is precertification required before I attend psychotherapy?
- If precertification is required, what are the steps?
- Number of psychotherapy sessions allowed per year.
- Deduction that must be met before benefits kick in. Ask for in-network and out-of-network deduction requirements-sometimes they differ.
- How much money will I be reimbursed for an individual psychotherapy session (code #90834, 38-45 minutes or code #90837, 53+ minutes) with an out-of-network provider?
- Some insurance companies do not cover marriage, couple or family therapy sessions (code #90847). If you are seeking couple or family counseling, be sure to get that information.
- If they say that they cover a percentage of the “Usual and Customary rate”, ask them to tell you what the usual and customary fee is (dollar figure).
I can provide clients with a coded receipt of their charges and payments at the time of each session or if they prefer I will provide a statement that includes a group of visits. My charge for individual, couple and family therapy is $150 for a 50-minute session and $225 for an 80-minute session.
You must be Diagnosed with a Mental Disorder to Receive Reimbursement from your Insurance Company.
In order to be reimbursed for any type of mental health treatment delivered by any mental health provider, your insurance company will require a diagnostic code that represents the mental disorder for which you are being treated [according to the criteria set forth in the DSM-V, the Diagnostic and Statistical Manual of Mental Disorders]. You will want to fully discuss the diagnosis with your therapist prior to that information being shared with your insurance company.