Out of Network Option

Insurance companies may reimburse patients for a percentage of the cost of services.  What this means is that, you will pay the full session fee ($150) and receive a superbill to submit to your insurance company as documentation for reimbursement.  

Before your first visit, call your insurance company (number listed on your ID card) and ask questions about your benefits. Be prepared to ask them the following questions:

1. Do I have out-of-network mental health benefits?
2. Are services rendered by a licensed clinical social worker covered?
3. Do I have a deductible and if so, what is it?
4. Are my mental health and medical deductibles separate or combined? (If they are combined, you may have already met your deductible with medical expenses).
5. If I have out-of-network benefits, will I be reimbursed the full amount I paid or a portion?
6. What documentation needs to be submitted for reimbursement?

Note:  You can often determine in advance what you will or will not be reimbursed by providing your plan administrator with what is called a “CPT code” (which, for our therapy session, is typically 90837) my NPI#1205446523, and our office zip code, which is 78731.

Good Faith Estimate

Under the No Surprises Act, you have the right to receive a ‘Good Faith Estimate’ (GFE) explaining the expected cost of your therapy services if you are uninsured or paying out-of-pocket. This estimate will outline the anticipated charges for services. If you receive a bill that is at least $400 more than your GFE, you may dispute the charge. For more information, visit www.cms.gov/nosurprises.