📋 How Therapy Insurance Works
Mental health coverage varies significantly by plan type and provider network. Understanding your benefits beforehand helps you navigate your care confidently.
In-Network vs Out-of-Network
In-Network: We have a contracted rate with your insurer. You'll typically pay only a copay or coinsurance per session.
Out-of-Network: You pay the full session fee upfront, but we provide a superbill for potential reimbursement from your insurer.
Deductibles & Copays
Deductible: The amount you must pay out-of-pocket before insurance begins covering services. Therapy usually falls under this category.
Copay: A fixed fee per session (e.g., $20-$50) once your deductible is met or if your plan covers therapy from day one.
PPO vs HMO Plans
PPO: Typically offers out-of-network benefits and flexible provider choice without referrals.
HMO: Usually requires in-network care only and often requires a primary care physician referral for therapy services.
🛡️ Accepted Insurance Plans
We are currently in-network with several major providers and accept out-of-network benefits for most others. Contact our billing team for the most up-to-date network information.
*Network participation is subject to change. We verify your benefits before your first session to ensure accurate coverage information.
✅ How to Verify Your Benefits
Follow these steps to check your mental health coverage before booking:
Call the Number on Your Card
Dial the member services number on the back of your insurance card. Navigate to the mental health or behavioral health department.
Ask Key Questions
Request your deductible status, remaining visits per year, copay/coinsurance amount, and whether individual therapy (CPT 90834/90837) is covered.
Check Our Network Status
Ask if "In Therapy" or your specific therapist is in-network. If out-of-network, request your out-of-network deductible and reimbursement rate.
Confirm with Our Office
Share your findings with our billing team. We will run a real-time verification to confirm your benefits and estimated out-of-pocket costs.
📄 Out-of-Network Reimbursement & Superbills
If you don't have in-network benefits or prefer to use an out-of-network provider, we make the reimbursement process straightforward.
- Superbill Provided: After each session, we issue a detailed receipt (superbill) containing our NPI, tax ID, diagnosis codes (if applicable), CPT codes, and session notes summary.
- Submit to Insurer: Upload or mail the superbill to your insurance company's patient portal or claims address within 60-90 days.
- Reimbursement: Most plans reimburse 50-80% of the session fee based on your plan's allowed amount. Funds are typically deposited into your bank account within 2-3 weeks.
- Tax Deductible: Therapy sessions qualify as medical expenses and may be deductible on your federal tax return (IRS Pub 502).
💳 Self-Pay & Flexible Payment Options
Insurance isn't the only way to pay for therapy. We offer multiple options to ensure care remains accessible:
Sliding Scale
Based on household income and financial need, we reserve a portion of appointments for reduced-rate sessions. Available weekly upon verification.
FSA / HSA Accounts
Therapy is an eligible expense. Use your Flexible Spending Account or Health Savings Account cards to pay directly at checkout.
Payment Plans
Pre-pay for 4, 8, or 12 sessions to secure your therapist and receive a 5-10% discount on the total package price.
Self-Pay Rates
Individual: $120-160/hr
Couples/Family: $160-200/hr
Intake Assessments: $200-250
Pay by card, ACH, or secure portal.
❓ Insurance & Billing FAQ
Currently, we do not accept Medicaid or Medicare. We do, however, offer sliding scale options and accept most major commercial PPO and HMO plans.
This depends entirely on your plan type. PPO plans rarely require referrals, while HMO or EPO plans typically do. We can help you verify this during intake.
Denials happen, but we assist with appeals when appropriate. You can contact your insurer's appeals department, and we can provide additional clinical documentation to support medical necessity.
Yes! Many Employee Assistance Programs cover 4-8 counseling sessions per year. We can coordinate directly with your EAP vendor or provide documentation for session tracking.
We require 24-hour notice for cancellations or rescheduling. Sessions canceled within 24 hours or no-shows are subject to the full session fee, as insurance plans typically do not cover missed appointments.
Have Billing or Coverage Questions?
Our billing specialists are available Monday–Friday, 9am–5pm EST to help verify your benefits, explain out-of-pocket costs, and guide you through payment options.
Contact Billing Department