Inquiring About Insurance Reimbursement
It is the responsibility of the client to determine if they are eligible for full or partial reimbursement for their out-of-network mental health services. If you do have reimbursement benefits, you are responsible for paying the full session fee at the time of the session, and then you may submit a claim to your insurance following the session. Your therapist at Coastal Woods Psychology can provide you a “superbill” for your sessions, which includes the necessary information for your claim. You may take the steps below to learn about your benefits prior to starting therapy. We hope this is helpful!
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It is your responsibility to contact your insurance company to determine your out-of-network reimbursement benefits. You may find the “member services” number on the back of your insurance card.
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Here are some questions you may ask:
“Does my plan include out-of-network benefits for mental health services or outpatient psychotherapy?”
“Does my plan set limits on the number of sessions per calendar year?”
“Does my plan have a deductible for out-of-network mental health services? If so, how much do I need to pay before my plan will reimburse me for any session fees I pay out of pocket?”
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If you do have reimbursement benefits, you may ask:
“What is the maximum amount you will reimburse me for various CPT codes (also known as the procedure codes)?”
The commonly used CPT codes for therapy include:
90791 (the first intake appointment or “psychiatric diagnostic evaluation”)
90834 (a standard 45-minute individual psychotherapy session)
90837 (an extended 60-minute individual psychotherapy session)
90847 (a 50-minute couples or family psychotherapy session)