Fees and Insurance
I’m out of network and private pay. Here’s exactly what that costs and what you can expect back.
Vague pricing costs more clients than the price does, so here it is plainly.
Session fee
[$XXX] per 50-minute session.
Payment is due at the time of session. [Methods accepted.]
I'm out of network
I’m not paneled with any insurance company. That’s a deliberate choice — it keeps the work between us rather than requiring a diagnosis on file with an insurer and a treatment plan justified to a third party.
It also means you pay me directly.
Superbills
I provide a superbill after each session — an itemized receipt with the codes your insurer needs. You submit it to your plan and they reimburse you directly, according to your out-of-network benefits.
What reimbursement usually looks like
This varies by plan, and I can’t tell you what yours will do.
Generally: out-of-network mental health benefits have their own deductible, separate from your medical deductible. Once it’s met, plans commonly reimburse a percentage of what they consider a reasonable rate — which may be lower than the actual fee. Some people get a substantial portion back. Some get nothing.
Find out before you start, not after.
Questions to ask your insurer
Call the number on your card and ask:
- Do I have out-of-network outpatient mental health benefits?
- What’s my out-of-network deductible, and how much have I met?
- What percentage do you reimburse after the deductible?
- Is that percentage of the billed amount or of an allowed amount? What’s the allowed amount for CPT code 90837?
- Do I need pre-authorization?
- How do I submit a superbill, and what’s the deadline?
Write down who you spoke to and when.
Good Faith Estimate
You have a right to a written estimate of what treatment will cost. More about Good Faith Estimates.
A note on cost
If the fee isn’t workable, tell me on the consultation call. I’d rather point you toward a fit than have you stretch for a few sessions and stop.