therapy with grace
Anthem BC/BS Insured Clients
The Standard Fees:
55 minute follow up sessions $125 – length of typical session
55 minute session is $150.00 – length of initial session
Negotiated Rate with Anthem:
55 minute follow up sessions 103.96
55 minute initial session 120.73
Fees for longer or shorter sessions are adjusted accordingly for the standard fee as well as subsidized fees.
Please be aware Insurance does not cover any therapy in which the client does not have a psychiatric diagnosis such as Anxiety Disorder. This means couples therapy is not covered unless one or both partners has a diagnosis. Please read the article below for more information before deciding to bill insurance for therapy.
Why Self Pay is Preferable to Billing Insurance
If you choose to bill Anthem
You need to call your insurance company before your first appointment for pre-authorization. You pay your deductible and your share (co-pay). One person must be designated as the “identified patient” and given a psychiatric diagnosis that the insurance company accepts. All charges are ultimately your responsibility and will default to you if not paid by insurance in ninety days.
When calling your insurance company for preauthorization, ask these questions:
- Be sure that Grace Layton is an In-Network Provider for your Anthem plan (all plans are different). The National Provider Identifier (NPI) is 1508161571. If not, are there out of network benefits and what are they?
- Is pre-authorization required? If so, can I receive pre-authorization today? How many sessions? Verify that the following two CPT codes are authorized.
90791 – Psychiatric Diagnostic Evaluation
90837 – Psychotherapy 53-67 min.
- Do you have a deductible? How much is it? Has it been met for this year? When does the new year begin (some do not begin January 1, so this is an important question)?
- What is your co-pay? Do you have a coinsurance, if so, what percentage is it?
- What are the limits of coverage per year and lifetime?