Using Out-of-Network Benefits for Therapy

I am an out-of-network provider for most insurance plans besides Cigna and AmeriHealth Caritas.

This means I do not bill your insurance directly, but you may be eligible for reimbursement depending on your plan.

Insurance can be confusing, and I’m here to help you understand your mental health benefits and navigate your coverage.

What are out-of-network benefits?

Many insurance plans offer partial reimbursement for therapy with therapists who are no in-network.

Depending on your plan, you may be reimbursed for a portion of each session after meeting your deductible.

What to expect when using out-of-network benefits for therapy?

1. Verify your benefits

   We can review your coverage together, including your out-of-network deductible, reimbursement rate, and any requirements for submitting claims.

2. Pay or sessions

   Sessions are held virtually and last 50-55 minutes. Payment is due at the time of each session.

3. Submit for reimbursement

   I will provide a superbill that you can submit to your insurance for reimbursement. Reimbursement timelines vary, but it typically takes 30–60 days.

4. Ongoing support

   We can periodically review your benefits or answer question as needed.

Not sure what your plan covers?

Insurance plans vary in their coverage of mental health services. You may find it helpful to ask:

• Do I have mental health benefits?

• What is my out-of-network deductible, and have I met it?

• What percentage of the session fee will be reimbursed?

• What is the allowed amount for outpatient psychotherapy (CPT code 90837 or 90834)?

• Is there a limit to the number of sessions covered per year?

• Do I need pre-authorization for out-of-network therapy?

• How do I submit claims for reimbursement, and is a superbill accepted?

Have questions about using out-of-network benefits?

Schedule a free 15-minute consultation

to talk through your coverage and see if we’re a good fit.