for Therapy & Counseling

Can I use my insurance?

My practice is private pay which means that I collect my fees in full from you at the time of service, but if you have a PPO plan you can later submit a claim to your insurance company to take advantage of your out-of-network benefits. Your insurance company will mail you a check for the portion you are reimbursed for. If you are interested in using your out-of-network benefits, please let me know and I am happy to provide you with a superbill.

What is a superbill?

A superbill is a statement that contains all of the information necessary for you to submit an out-of-network claim to your insurance company: patient information, provider information, dates of services and amounts paid, diagnostic code(s), and procedural terminology.

How much will my insurance cover?

The amount that your insurance will cover depends on your particular plan’s benefits. If you would like to understand this ahead of time, I highly recommend calling your insurance company directly and asking these questions:

• Do I have out-of-network benefits?

• Is an outpatient office visit for psychotherapy part of my out-of-network benefits? Check CPT codes 90791 & 90834 for individual therapy, and 90847 & 90846 for couples & family therapy.

• Do I have an applicable deductible that I have to meet before my benefits kick in for therapy? If so, what is my deductible and once my deductible has been met, how much will insurance cover?

• Is there a fee limit my insurance allows? If so, what is the limit?

• Do I have an out-of-pocket max? If so, what is it?

• How do I submit out-of-network claims?

Please note, for insurance to consider therapy a covered service it must meet criteria for “medical necessity” which requires a diagnosis of a mental disorder. I do not view the people that I work with through a medical, disorder, or illness lens, but as with all therapists I am trained to do so and will assess and diagnose appropriately upon your request.

Does using insurance change the services that I receive?

No. We may have to use some of our session time to complete official assessments and symptom scales as part of a diagnostic assessment, but our work together will be the same beyond that.

Will my insurance have access to my therapy records?

Yes. Even though I am not contracted with your insurance company if you choose to submit out-of-network claims your insurance company will have the legal authority to audit your therapy records. Insurance companies do this for their own purposes of managing care as well as for providing data to the government about health care utilization and demographic statistics. It is also possible that insurance can audit your therapy records and determine that your treatment did not meet “medical criteria”, retro-actively deny your claim for out-of-network benefits, and ask for their money back.

Are there other things to consider when involving my insurance?

Yes. Having documented treatment for a diagnosed mental illness does currently impact other areas of life such as joining the military, life insurance coverage and premiums, and divorce and other legal proceedings to name a few. Aside from my mandated reporter duties, (see FAQs), if you need to be sure that your therapy is 100% confidential, I recommend not involving insurance.

Can I use my Flexible Spending Account or Health Savings Account to pay for therapy?

Yes. Medical necessity and a mental health diagnosis may be required to qualify as a medical expense. If you are unsure what qualifications need to be met in order to use your FSA or HSA to pay for therapy, please contact your account provider.

Can I write off my therapy costs or pay through my business?

Possibly. Please consult with your accountant or tax professional.

Why don’t you take insurance?

As you can see from all of the information above, there is a lot involved when working with insurance companies. I enjoy having the freedom to practice how I see fit, providing the best care and the most privacy for my clients.