- $200 - Intake Evaluation Session
- $150 - Individual Psychotherapy Session
- I am an in-network provider with Empire Blue Cross Blue Shield.
- I am an out-of-network provider for other insurance companies.
Depending on your current health insurance provider or employee benefit plan, it is possible for services to be covered in full or in part. Please contact your provider to verify how your plan compensates you for psychotherapy services.
I’d recommend asking these questions to your insurance provider to help determine your benefits:
- Does my health insurance plan include mental health benefits?
- Do I have a deductible? If so, what is it, and have I met it yet?
- Does my plan limit how many sessions per calendar year I can have? If so, what is the limit?
- Do I need written approval from my primary care physician in order for services to be covered?
It is understandable for clients to want to use in-network benefits, as using these can save a lot of money. However, be aware that when requesting insurance reimbursement for services from in-network providers, the following apply:
A diagnosis is required, and this label will be part of your medical record permanently.
Clients' records are not protected, which means that all information about the client, including very personal information, may be obtained by the insurance company.
For these reasons, many clients prefer to use out-of-network benefits, as insurance companies are very limited in the information they can request about clients using out-of-network benefits. Also, clinicians are better able to meet clients’ needs, instead of working for the insurance company!
To better understand what your insurance carrier might reimburse for out-of-network psychotherapy services, call your insurance company before scheduling an appointment or consultation. You may want to ask your insurance carrier the following:
- What do they reimburse for out-of-network psychotherapy services for the following CPT codes: 90791, 90834, 90837 (Your insurance company will understand what a “CPT code” is, and whether they reimburse for these specific codes).
- Is there a maximum number of psychotherapy sessions they will reimburse?
- Will the insurance company reimburse the following diagnoses (which are common for my clients to have): PTSD, anxiety disorders, adjustment disorder, and acute stress disorder.
While some clients may have additional diagnoses, these are the most common ones used in my practice, and it is helpful to know ahead of time if the insurance company will be willing to reimburse for the ICD-10 codes attached to these diagnoses.
If the insurance reimburses a percentage of the cost, what is that percentage, and what is the maximum total cost per session they are allowing?
For instance, they may reimburse 70% of a psychotherapy session (CPT code 90837), but assume that the total cost of the psychotherapy session is only $120 (instead of my actual rate). This would mean the client would be reimbursed $84 per session, after paying a rate of $250-$300 out of pocket. Another company, however, may only reimburse 50%, but allow a $220 hourly rate, meaning that the client would be reimbursed $110 per session.
Thus, it is important to understand both the reimbursement percentage and the maximum per-session rate allowed.
I accept cash, check, and all major credit cards as forms of payment. Fees, copays, coinsurance are due at the time of the session.
If you are unable to attend a session, please make sure you cancel at least 24 hours beforehand. Otherwise, you will be charged for the full rate of the session.
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