Basic questions to ask your insurance company:
- What are my benefits for outpatient psychotherapy?
- Do I have a deductible?
- If I meet with an out-of-network provider do I get reimbursed?
- If I meet with an in-network provider how much is my co-pay?
- Benefits for outpatient mental health treatment. Call your insurance company keeping in mind the following: the code for intake is 90791 (first visit only) and individual psychotherapy is 90837.
- Deductible: If you have to meet a deductible as part of your insurance plan, they will not pay for therapy until you have met that deductible. For example, if your deductible is $300 per calendar year, your coverage will not begin until you have incurred $300 in medical expenses.
- Out-of-network benefits: An “out-of-network provider” is a therapist who does not participate with your insurance company. However, if you have benefits for out-of-network therapy, you may still be able to get money back from your insurance company by submitting a “medical claim form” (usually found on insurance website) along with a receipt from the therapist. Your insurance company may then send you a check to reimburse you for part of the cost of therapy.
- In-network:I participate with: Blue Cross Blue Shield FEP, PPO and Magellan plans. I am also an out-of-network provider for other health insurances. If you are covered by the insurance plans I work with and don’t have a deductible, you only pay a co-pay for each visit (like you would for a doctor’s visit) and I submit the bill to your insurance company. The rate for private pay is $150 per 55 minute session. You can pay by cash, check or credit card.
Using a Flexible Spending Account
Some employers offer the option to deduct an amount from your salary pre-tax for medical expenses. Since therapy is considered a medical expense, you can include the projected expense for therapy in your medical option. In this way, you will be deducting the cost of therapy from your taxes. Check with your employer about this option.