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    Insurance Reimbursement

    I am currently an in-network provider for patients covered by traditional Medicare (NOT “Medicare Advantage”). If you are covered by traditional Medicare, I am required to directly bill the plan for you. For all other insurance plans, my services are considered as “out-of-network.”

    As a courtesy to my patients, I can file claims on your behalf at your request. Ultimately, you are responsible for paying for the costs of services. However, if you have out­of-network health care benefits as part of your plan, you may be reimbursed a portion of the fee by the insurance company.

    If you choose to utilize your out-of-network benefits, your insurance plan may choose to cover all, some, or none of these services. Therefore, before your first session, I strongly suggest you contact your insurance company to verify if your plan includes out-of-network coverage for outpatient mental health services.

    To find out if you have out-of-network benefits and what portion of the fee they may cover, please contact your insurance company directly by calling the customer service phone number on the back of your insurance card (there is often a separate phone number for mental health or “behavioral health” services information).

    When speaking with your insurance company, you will want to ask them the following questions:

    • What are my “out-of-network” outpatient mental health insurance benefits?
    • What is my deductible and how much of it have I met?
    • Is it possible to meet with a provider that I choose and submit receipts for reimbursement?
    • Are there any limitations on how many services a year that will be covered?
    • What is the coverage amount per therapy session
    (CPT codes: 90837 (55 min) or 90834 (45 min))?
    • How long will it take to get my reimbursement?
    • Do I need a referral from a primary care physician?
    • Do my benefits cover telehealth services (online psychotherapy sessions)?