I am an "out of network provider," and collect payment from you at the time of the session. I provide you with a statement that can be submitted to your insurance company for reimbursement. I will provide your insurance company with additional information needed for payment processing. You can pay me by personal check at the time of service.

What questions do I pose to my insurance provider?

Typically, reimbursement is provided on a percentage basis, and there is no co-pay option.Your insurance provider can provide answers to the following questions:

  • What are your mental health benefits, and what is your annual deductible for mental health services?
  • Is your annual deductible for physical health services separate from your annual deductible for mental health services?
  • What is the plan coverage for an "out of network provider" who is a licensed clinical psychologist?
  • How many therapy sessions are covered in a calendar year?
  • What percentage of coverage is based on the clinical psychologist's actual fee?
  • If your coverage is based on "reasonable and customary fees," what is the maximum fee for a clinical psychologist's services for the following types of service:
    • 75 minute initial evaluation session (CPT code 90791)
    • 50 minute individual psychotherapy session (CPT code 90834)
    • 25 minute individual psychotherapy session (CPT code 90832)
    • 50 minute family therapy session (CPT code 90847)
    • 75 minute group therapy session (CPT code 90853)
  • Does the insurance company place a cap on the amount of reimbursement?

Can I use a flexible spending account?

You can minimize your out-of-pocket expense by using a flexible spending account. This enables you to use pre-tax dollars for medical expenses and deductibles that are not reimbursed.