Contacting Your Insurance

Most insurance cards have a phone number on the back of the card to inquire about behavioral health benefits. Questions that can help to guide this conversation are:

  • Does my insurance plan include behavioral health benefits?

  • Do I need to see specific providers who are in network with my plan?

  • What is my copay (i.e., fixed session cost) for therapy sessions? Do I have to pay co-insurance (i.e., percentage of the session cost)? 

  • Do I have a deductible to meet before my copay or co-insurance begin, and have I met it?

  • What types of sessions are covered? 

    • Insurance claims are filed using CPT codes, and the ones relevant to our work would be 90791 for the initial intake and 90837 for 55 min sessions. You can also ask about whether or not out of office sessions (i.e., in the community) are covered, as well as telepsychology sessions (via phone or HIPAA-compliant video platform). You can also ask about whether or not a specific video platform is required for reimbursement (I use Doxy.me and the Simple Practice system's telepsychology platforms).

  • Do I need a referral from my primary care physician to begin therapy?

  • (If using out of network benefits): I want to see a psychologist out of network with an hourly rate of $200. What can I expect for reimbursement?

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