an insurance guide
for psychotherapy services

 

I do not accept insurance. However, I can provide you with a monthly “superbill” you can submit to your insurance company for reimbursement. If you plan to use your insurance, you should contact them before we see each other to verify what, if any, coverage you have.

 

The following is a list of potential questions that may be helpful when contacting your insurance company prior to your first appointment:

 

1. What are your mental health benefits?

2. How many sessions does your plan allow? Is there a limit on the number of sessions covered? Is there a limit on the length of sessions?

3. Can you see a therapist out of network?

4. If you see a therapist out of network, how much will your insurance pay?

• The answer is often: “a percentage of usual and customary” based on the zip code where services are being offered. Don't forget to ask about "usual and customary" services for “telehealth services” if you will be seeing your therapist via telehealth.

• Usually, reimbursement also depends on the diagnosis. There may be some diagnoses that your policy does not cover.

• Some reimbursement is contingent upon the type of session (e.g., initial session, on-going visit, phone session, etc.)

  5. What will your insurance carrier need from your therapist        in order to provide reimbursement?

• Can you submit your therapistʼs invoice or superbill, or do they require a special form?

  6. How long will it take to get reimbursed?

 

Note: Some insurance companies make special provisions for their clients who are already seeing a therapist. Occasionally, that therapist can be designated “in-network” for your case alone. This may involve extra work on the part of your therapist, but it might be worth asking your insurance carrier about.