Rates

 This is the first question to ask your insurance provider to determine if you have access to out-of-network benefits for therapy. 

Some plans may restrict out-of-network benefits for telehealth services. Confirm whether telehealth is covered. 

Your deductible may be different for out-of-network services and in network services. Your deductible is the amount you need to pay before your insurance company begins paying towards your services. 

 Knowing this amount helps you understand how close you are to your insurance starting to reimburse you. 

 Some insurance plans require a referral before they will reimburse for out-of-network providers. Check to see if this applies to you. 

 Insurance companies often reimburse a portion of session costs. This helps you calculate your out-of-pocket expenses. 

 The CPT code is a code that insurance companies and providers use to categorize the services you receive. The 90837 CPT code is the code for individual psychotherapy for 53-60 minutes. You want to know what their allowance is for this as it will affect how much you are reimbursed. 

 The CPT code 90834 refers to a standard 45-minute therapy session. Ask about the reimbursement rate for this specific service. 

 Insurance companies may reimburse a set percentage of the allowable amount. Find out what percentage applies to you. 

Many insurance companies have easy to navigate websites or apps that allow you to do a member submitted claim where you will input the information from the superbill into their portal and upload the document as well. Some insurance companies require you to fill a PDF form and send it via chat. Knowing how to submit will ensure you are reimbursed properly. 

 Some insurance companies allow online submissions, while others require physical forms. Understanding the process will streamline your reimbursement. 

 Processing times can vary greatly between insurance companies. Knowing what to expect can help you plan financially.