USING INSURANCE FOR THERAPY SESSIONS

Oklahoma: private pay, and out-of-network health plans.

Texas: private pay, and out-of-network health plans.

I am not in network with insurance plans, but your plan may offer out-of-network benefits, reimbursing part of the session cost after you meet your deductible. To make this easier, I recommend using Thrizer to handle the reimbursement process for you. With Thrizer, you only pay your co-insurance upfront, rather than my full fee, and they take care of the rest.

Not sure if you have out-of-network coverage? Thrizer can check your deductible and out-of-pocket costs for free.

I do not receive any financial benefit or compensation when clients use Thrizer.

If you prefer to file your own claim for out-of-network benefits, I can provide you with a document called a “Superbill,” which you can submit to your insurance company for reimbursement. Please check with your insurance provider about their submission process and the expected timeframe for receiving reimbursement.

Insurance & Therapy: What You Need to Know About Privacy and Coverage

  • When using insurance for therapy, your therapist is required to provide a mental health diagnosis to submit a claim. The diagnosis becomes part of your permanent medical and insurance records, which may be accessible to insurance companies or government agencies. These records could potentially impact future insurance benefits, job applications requiring security clearance, or healthcare checks. It’s important to consider how this might affect you now and in the future.

  • Insurance companies impose restrictions on which diagnostic codes they will cover and may limit or deny the number of sessions. They only cover services that meet "medical necessity criteria," meaning therapy must be focused on treating diagnosable mental health symptoms, rather than personal growth, self-improvement, or general support.

  • Using insurance involves some loss of confidentiality. Insurance companies have the right to request your therapy records, including your diagnosis, treatment plan, and progress notes for audits or reimbursement purposes. While they are required to keep this information confidential, once it's in their system, you have little control over how it is used.

    If maintaining full control over your mental health care and keeping it completely confidential are your top priorities, paying out of pocket for therapy may be the ideal option.

You can consider putting funds into a Health Savings Account (HSA) or Flexible Spending Account (FSA) at the beginning of each year. This is tax-deductible money that you can use to pay for your therapy sessions. These accounts typically come in the form of a credit card.

No Surprises Act

Under the federal law “No Surprises Act” implemented in January of 2022, health care providers are required to inform individuals who are not enrolled in a plan or coverage or a federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing.

You are entitled to receive a “Good Faith Estimate” of what the charges could be for psychotherapy services provided to you. While it is not possible for a counselor to know, in advance, how many psychotherapy sessions may be necessary or appropriate for a given person, the Good Faith Estimate provides an estimate of the cost of services provided. Your total cost of services will depend upon the number of psychotherapy sessions you attend, your individual circumstances, and the type and amount of services that are provided to you. This estimate is not a contract and does not obligate you to obtain any services, nor does it include any services rendered to you that are not identified.

If you are billed for more than the Good Faith Estimate, you have the right to dispute the bill.

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call CMS at 1-800-985-3059.