I am out-of-network for insurance plans. My clients utilize my services on an "out-of-network" basis, or pay for the services out of pocket.

 

Private Pay/Out-of-Network 

If you would like to use your out-of-network coverage from your insurance, please contact your insurance company prior to our first meeting and ask about the out-of-network reimbursement rate for outpatient tele-psychotherapy. The specific amount of this reimbursement depends on your plan. Upon request, I will provide you with the statements your insurance requires for reimbursement. Payment is due at the time of service.

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Benefits of Private Pay for Psychological Services 

• No restrictions on how many sessions per year or how often you get to see your therapist.

• No restrictions on telehealth/online therapy.

• No need to change your therapist if you change your insurance plan with work.

• No need to share your mental health information with insurance companies. 

• Freedom to choose a therapist who can be the best fit for you instead of being limited to therapists who are within network of insurance companies. 

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Questions to Ask Your Insurance about Out-of-Network Coverage

• Do I have out-of-network coverage for outpatient mental health services? 

• If yes, what is the coverage for before and after I reach my deductible?

• How much is my annual deductible? How much has it been met this year? 

• Does my expenses with out-of-network providers count towards the deductible? 

• What is the specific percentage or dollar amount coverage for out-of-network outpatient mental health services? (You can use the CPT code 90791 for intake and 90834 or 90837 for on-going sessions to check the specific coverage).

• Is telehealth/online therapy covered by my out-of-network benefits?

• What information do you need for me to submit for out-of-network reimbursement?

• Do I need a referral to see out-of-network providers? If so, where can I get the referral?