My psychotherapy fee is $250 for a regular 45-minute session. My fees for psychoanalytic sessions may vary and are negotiated individually.
YES, you CAN get your psychotherapy and psychoanalysis* covered by your insurance. Using your insurance can significantly reduce your out-of-pocket expenses for psychotherapy and psychoanalysis. Many people neglect to check into their insurance plan when they go to an out-of-network provider. In fact, researching health insurance plans during the open enrollment period and choosing the plan with the optimal mental health benefits can make psychotherapy very affordable. See examples below.
Health insurance plans vary: some of them have modest coverage for out-of-network mental health benefits, and some of them would cover most of your costs. To find out about your insurance plan coverage and how your psychotherapy expenses are going to be covered, call your plan’s customer service and ask the following questions:
- What are my out-of-network mental health benefits?
Here, you will find out about your deductible, your co-pay or co-insurance, and the percentage of the fee that is covered by your plan.
- What is the allowable amount for a licensed professional counselor in zip code 20009 for CPT code 90834?
You will be quoted the allowable amount for an individual psychotherapy session.
- Where and how do I submit my provider’s bills?
You will be told to mail, to fax, or to electronically submit your bills. Make sure to write down the corresponding mailing address, the fax number, or the webpage.
- Suppose, you have a standard PPO plan with a $300 deductible, after which your out-of-network expenses (up to the allowable amount) are covered, with you responsible for $25 copay per session. Your out-of-pocket expense per session would equal the fee amount – allowable amount – $25.
- You may have an HMO or EPO plan. These would typically not cover any out-of network expenses. If you know that you will be using mental health benefits, be strategic and look into a different plan that would cover your out-of-network sessions. In the long term, it might save you a lot of money and provide you with access to high-quality treatment.
- High-deductible plans can often be a great value, particularly when it comes to mental health out-of-network coverage. Despite of the initial shock of the high deductible – often $2,000-$3,000 – they may offer great savings in the long run. Once the deductible is met, usually in 13-20 sessions (which could be in as short as 2 months), your expenses may be covered at 70%, with 30% co-insurance of the allowable amount.
*Because psychoanalysis is a type of psychotherapy, it is treated as psychotherapy for insurance billing purposes.