Using Insurance for Therapy SessionS

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

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

While I am not in network with insurance plans, your plan may have out-of-network benefits, which means that they will reimburse you for a portion of our session cost. I have partnered with Thrizer to handle the out-of-network process automatically for you. With Thrizer, you will only have to pay your co-insurance for our sessions, instead of paying my full fee and waiting for reimbursements. I can help you verify if you have out-of-network benefits and how much your co-insurance would be.

If you prefer to file your own claim for out-of-network benefits, I will provide you a document called Superbill so you can submit to your insurance company for reimbursement. Please contact your insurance company about the process of submitting superbill.

Understanding the Impact of Using Insurance for Therapy

  • When you use 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. These records may be accessible to insurance companies or government agencies, which could affect future insurance benefits, job applications requiring security clearance, or healthcare checks. Consider how this might impact you in other aspects of life and in the future.

  • Insurance companies put restrictions on what diagnostic codes they will pay for and which they won’t. They may also deny or limit the number of sessions covered. Insurance companies only provide coverage for services that meet “medical necessity criteria.” This means therapy sessions must focus on reducing diagnosable mental health symptoms, not on self-improvement, personal growth, 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 promise to keep this information confidential, once it’s in their system, you won’t have control over how it’s used.

    If taking charge of your mental health care & 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 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.