Rates

How does reimbursement work if you're out-of-network?

Because I'm not paneled with any insurance companies, you pay the session fee directly at the time of service. If your plan includes out-of-network (OON) mental health benefits, your insurer may reimburse you for part of what you've paid. To make that possible, I provide a superbill — an itemized receipt — that you submit to your insurance company.

Will my insurance definitely reimburse me?

Not always. It depends entirely on your plan. Some plans reimburse a generous percentage of out-of-network care, others reimburse little or nothing, and many only begin reimbursing after you've met an out-of-network deductible. The most reliable way to know is to call your insurer before we begin (see the questions below).

Does reimbursement change what I pay you?

No. You pay the full session fee directly to me. Any reimbursement is a separate matter between you and your insurance company.

How do I find out what my plan covers?

Call the member services number on the back of your insurance card and ask:

• Do I have out-of-network outpatient mental health benefits?
• What is your reimbursement rate for out-of-network mental health providers?
• Do I have an out-of-network deductible, and have I met it yet?
• Is there a limit on the number of sessions per year?
• Do I need pre-authorization or a referral before starting?
• How do I submit a superbill, and is there a filing deadline?

What details will they ask for?

It helps to know the service (CPT) code for your sessions — I'm happy to tell you which codes apply — and to confirm how they accept claims (mail, fax, online portal, or a reimbursement app).

How long does reimbursement take?

That varies by insurer, but it's often a few weeks after a complete claim is submitted. Keeping a copy of every superbill and claim makes it easier if anything needs to be resubmitted.

What is a superbill?

A superbill is an itemized receipt for the therapy services you've paid for. It lists the dates of service, the service (CPT) codes, a mental health diagnosis code, my practice and license information, and the amount you paid — everything your insurer needs to consider reimbursement.

Does a superbill require a diagnosis?

Yes. Insurers generally require a billable mental health diagnosis on the superbill in order to reimburse. If you have questions about what that means for you, I'm glad to talk it through before we begin.

How and when will I receive mine?

I provide superbills on request, typically on a monthly basis. Just let me know and I'll prepare one for you, and I'd recommend saving a copy of each for your own records.