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Clinical Review: All medical and clinical information in this article has been reviewed for accuracy by Jordanne Sculler, LMHC.
Navigating insurance for mental health services is a common concern for new patients. In many cases, health insurance plans do offer coverage for psychotherapy, but the extent of that coverage depends entirely on your specific policy, your provider's network status, and the nature of the treatment.
If a therapist is "in-network," they have a direct contract with your insurance company, meaning you are typically only responsible for a copayment or coinsurance at the time of your visit. If a therapist is "out-of-network," they do not bill your insurance directly. However, many insurance plans feature out-of-network benefits that will reimburse you for a portion of the session cost.
My practice is private pay only and I do not participate as an in-network provider with any insurance panels. This allows me to provide highly personalized care without the limitations, restrictions, or diagnostic requirements often dictated by insurance companies.
Clients pay for sessions at the time of service. For those with out-of-network benefits, I provide a monthly superbill that can be submitted directly to your insurance company for potential partial reimbursement, depending on your individual plan and deductible.
I am happy to discuss how out-of-network benefits work and what questions to ask your insurance provider during our consultation so you feel informed and supported in navigating this process.
If you are planning to use out-of-network benefits, it is generally recommended to call the member services number on the back of your insurance card before starting therapy. Consider asking the following questions:
Transparency around fees is an important part of my practice. A Good Faith Estimate will be provided in accordance with the No Surprises Act to help you understand expected costs for services.
If you have any questions or would like further clarification regarding fees or your Good Faith Estimate, please feel free to contact the office at any time.