Rates, Insurance, and Payment
$205 per 50-minute session
$255 per 75-minute session
I am considered an "out-of-network provider" for all insurance companies and do not file any claims directly to insurance.
I obtain payment from you and provide you with a statement (a superbill) that you may submit to your insurance company. If you have out-of-network benefits, your insurance company may reimburse a percentage of what you have paid, according to your plan's out-of-network benefits coverage.
Many insurance companies offer out-of-network benefits. However, it is recommended that you discuss your health care benefits with your insurance company. Below you will find questions that could help clarify your coverage.
My hope is that you will be able to utilize your plan’s out-of-network benefits to off-set the cost of therapy from your pocket.
I recommend asking the following when you call Member Services:
Does my plan have Out-of-Network Benefits?
If so, please explain the terms
What is my deductible before out-of-network benefits kick in?
What percentage of out-of-network expense is covered? For example, a 60-minute therapy session (CPT code 90837) is $205. Is the out-of-network reimbursement a percentage of that? Or is it a percentage of the insurance company’s reimbursement rate?
What are the different rates of reimbursement for different CPT codes? For example, a 45-minute therapy session (CPT 90834) vs. the 60-minute session (90837) or an initial evaluation (CPT 90791)?
I also suggest discussing your benefits options with your Human Resources representative and looking at the coverage plans available to you during the Open Enrollment period. There may be plans that provide better out-of-network coverage. The Open Enrollment time is also a good time to enroll in and take advantage of (if you haven’t already) a Flex Spending Account (FSA) or Health Savings Account (HSA).
Utilizing a FSA or HSA can help decrease the burden of paying out-of-pocket for ongoing therapy (and additional medical expenses). For the 2021 year, the FSA max is $2750, the HSA max is $3500 for an individual and $7100 for a family.
Here is a link to more information about FSAs: https://www.thebalancecareers.com/maximize-your-employment-benefits-1289277
I realize that it can be challenging to find an in-network therapist and many people often wonder why. If you're interested, please read the following articles which help to explain some of the reasons why 1) it can be hard to find a therapist who accepts your insurance and 2) articulates some of the struggles which have led me to end my contract with Carefirst/BCBS and be an out-of-network provider.
This article speaks to much of my reasoning and reflection to be an out-of-network provider:
Cash and check are my preferred methods of payment. However, given the COVID-19 pandemic and move to virtual services, major credit cards, health savings & flex spending cards are also accepted.
If you do not show up for your scheduled therapy appointment, and you have not notified me at least 48 hours in advance, you will be required to pay the full cost ($205 or $255) of the session.