Out Of Network Reimbursement

The Standard Fees:

45 minute session is $100.00

60 minute session is $125.

75 minute session is $150.00

Fees for longer or shorter sessions are adjusted accordingly for the standard fee as well as subsidized fees.  I am happy to email further details on fees.

 

Before deciding to Bill Out of Network Insurance for therapy, please read the following article:

 

Why Self Pay is Preferable to Billing Insurance 

 

If you choose to bill for Out of Network Reimbursement:

In each session, you will pay me the standard fee.  I will then give you a receipt with all of the information you will need to send to your insurance company for reimbursement.  You will send the receipt to your insurance company.  They then will either make a note of what you have paid for therapy and put it toward your deductible or, if you have met your deductible, they will send you a reimbursement check for all or a percentage of the session (the answer to this question will be answered when you call them before beginning therapy).  I do not hold responsibility for you being reimbursed by your insurance company.  Your agreement with them and with me are separate.  It can take several months before insurance reimburses for services.

 

The following is important information you will need in order to receive reimbursement from your insurance provider:

 

I will be considered an out-of-network therapist.  Prior to beginning therapy with me you will need to call your insurance company to find out your out-of-network benefits.  To insure you will receive reimbursement from your insurance company you will need to call them before your first appointment for pre-authorization.  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.

 

When calling your insurance company for preauthorization, ask these questions:

90791 – Psychiatric Diagnostic Evaluation
90832 – Psychotherapy 16-37 min.
90834 – Psychotherapy 38-52 min.
90837 – Psychotherapy 53-67 min.
90839 - Psychotherapy for Crisis 30-74 min.
90847 - Family Therapy Pt present
90846 - Family Therapy Pt not present
An initial authorization is usually for three to ten sessions. Additional authorizations typically require an “Outpatient Treatment Report.” These are written by me (Grace Layton) and call for clinical information about why you originally came, goals, progress, assessment of functioning, etc.