Fees & Insurance
Understanding Insurance Coverage & Reimbursement
I am an out of network provider for all insurance plans. That means that I don’t accept your insurance directly. Some insurance companies will reimburse you or not reimburse at all depending on whether you see a provider with whom they have a contract, called an in network provider, versus an out of network provider.
Please check your coverage by calling your insurance company and be sure that you understand this coverage before the first appointment. I provide super bills/receipts after each appointment that can be submitted directly to your company for reimbursement. If you have out of network benefits, your company will process each receipt and send you a check for the portion of the fee for which they are responsible or apply that amount to your deductible.
Obtain any special forms in advance of the first appointment. Some companies require psychologists to complete treatment plan and/or psychological testing authorization forms to request approval for appointments. I’m happy to complete these types of forms if you provide them. I am not in control of how quickly they will process requests or how many sessions they will authorize.
Call your insurance company before the initial appointment. Indicate that you’re calling about your in and out of network benefits. This should help you to be forwarded to the correct department.
Here are some questions to get you started:
- What are my in and out of network benefits?
- What is my deductible and has it been met?
- How much does my plan cover for an out of network provider?
- How many sessions per calendar year does my plan cover?
- If you are told that it is a percentage, for example, 80%, ask “What is the allowed amount per visit?”
- What is the address I should use when submitting receipts for reimbursement?
- Is there a treatment plan that the psychologist needs to complete? What is the fax number or e-mail address to send the completed form?
Tell them you would like to know the allowed amount for the following procedure codes:
- Diagnostic interview/ initial appointment (CPT 90791 )
- Individual therapy (CPT 90834 and 90837)
- Family therapy (CPT 90847)
When the appointments are for psychological and psychoeducational testing:
- Psychological test administration and scoring (CPT 96136 and 96137 – 30 minute units)
- Psychological test scoring/interpretation/integrative report (CPT 96130 and 96131 – 30 minute units)
Understanding Fees & Costs
Payment for services is due at the time of each appointment. Cash, checks and credit cards are accepted.
Prior to the initial appointment, I give new patients/parents a written fee schedule describing the costs of care in my office. This document, together with information from your insurance company about your out-of-network deductibles, copays and the allowed amount they reimburse for services, gives information about patients/parents estimated share of the costs before the initial appointment. This written document fulfills the responsibility to provide clear and understandable information to protect consumers against unexpected medical bills established primarily for hospital and clinic facilities under the No Surprises Act of 2022.
410-881-2111