Fees and Insurance
I am an out-of-network provider. Many plans, including Cigna, Blue Cross Blue Shield, Oxford, Aetna, and GHI, have out-of-network coverage. This means that the insurance company will reimburse all or a portion of the fee.
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If you are not sure if you have out-of-network coverage, I recommend calling the member services number (on the back of your card) and asking the questions laid out on this page.
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My typical fee is $230 for a 50 minute session. I have a few sliding scale openings that fill up quickly.
Understanding Your Insurance Coverage: Steps to Follow
1
Call your insurance company's member services line.
The number is usually on the back of your insurance card.
2
Ask if you have out-of-network coverage.
Specifically, ask if you have out-of-network coverage for outpatient mental health services.
3
Ask if you have an annual deductible.
Typically, insurance plans have a yearly deductible for all physical and mental health services. You need to meet that deductible before the insurance company will reimburse you for services. Find out when the yearly deductible starts and ends (e.g., January though December.) Also, ask how much of the deductible you have already met.
4
Ask what your co-insurance is for each visit
Once you've met your annual deductible, the insurance company will pay a percentage of the visit. When you ask what percentage they pay, the insurance company might ask for a code for the visit. You can use CPT code 90834. Also, ask if they have a maximum rate that they reimburse. For example, if they pay 80% of a visit, you'll want to know if that's for any rate or if they calculate it based on a maximum rate for New York City.
5
Ask if there is a cap on the number of visits that will be covered in a year.
Some plans allow an unlimited number of visits while others set a maximum number that will be covered.
Please feel free to be in touch if you have additional questions or don't understand something. Insurance coverage is complicated and I'd like to help!
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Get in Touch
Contact me through the Contact form or email me directly at annehellertherapy@gmail.com