Payment is due at each session and is conducted through credit or debit card auto-pay billing with the card you provide. Your payment card will be billed after your session. For those using in-network insurance, it may take a few days for your card to be billed for your copay amount.

With in-network insurance billing, your insurance is billed directly, and your payment responsibility is whatever the copay is for your specific insurance plan.

With out-of-network insurance billing, you are privately paying for your therapy sessions and then seeking reimbursement from your insurance company.

Please note for both in-network and out-of-network insurance billing, your insurance company requires medical necessity in the form of a mental health diagnosis for you to use their services and benefits. Additionally, your insurance may legally ask for additional information without your prior authorization for billing or audit purposes. This can include assessments, treatment plans, and progress notes which are part of your mental health record.

Before starting therapy, I will collect your insurance information through the respective billing company (either Alma or Headway depending on your insurance) and they will run an eligibility check to get an estimate of your insurance coverage, including the amount of your copay.

I strongly encourage you to also reach out to your insurance company directly to confirm your mental or behavioral health coverage, including your copay, deductible, whether your deductible applies to mental or behavioral health services, if any prior approval is required for mental or behavioral health services, and any limits to the number of sessions covered.

Once we begin therapy, I will submit claims to your insurance company for your sessions and you will be charged the copay amount determined by your insurance company.

You privately pay me the agreed-upon fee for your therapy sessions, and I provide you with a monthly superbill to submit to your insurance company for possible reimbursement. If you are eligible for reimbursement, your insurance company will reimburse you directly.

Typically, HMO and EPO plans do not include out-of-network benefits, whereas PPO and POS plans do include out-of-network benefits, however, each insurance plan is unique.

If you are interested in out-of-network insurance billing, I encourage you to contact your insurance company to explore your out-of-network coverage for mental or behavioral health care before beginning therapy, as the availability and amount of reimbursement is determined by your specific insurance plan. Unfortunately, I am unable to guarantee whether your insurance will provide reimbursement for the services provided to you.

Some questions that may be helpful to ask your insurance company include:

• Do I have mental or behavioral health out-of-network benefits for outpatient settings?

• What will the coverage (reimbursement) amount be per session?

• Do I have a deductible I have to meet before receiving reimbursement for out-of-network sessions? If so, what is my deductible amount? Has it been met?

• Is prior approval required by my primary care physician?

• Do you cover telehealth sessions or have any stipulations on it?

• How many mental or behavioral health sessions does my plan cover annually?

• How do I obtain reimbursement for out-of-network mental or behavioral health services?

Diagnoses are technical terms that describe the nature and duration of the challenges you are experiencing. All diagnoses come from the most current version of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM).

Insurance companies require medical necessity in the form of a mental health diagnosis for you to use their services and benefits.

I welcome any questions you have about this diagnostic assessment and determination and am happy to include you in this process if you are interested. I always seek to utilize the most accurate and least pathologizing diagnosis that is available and representative of the challenges you are experiencing.

A copay or copayment is the amount of money you are responsible for paying for the services that are provided to you when using your insurance for in-network services. This amount is determined by your insurance company for your specific plan and can be impacted by whether or not you have met your deductible. Your copay can also change over time depending on fluctuations in your insurance coverage.

A deductible is the amount of money you have to spend each year on eligible healthcare services before your insurance company will begin paying for a portion of your healthcare costs. The amount of your deductible is determined by your insurance company for your specific plan. For plans that have a higher deductible, you may be responsible for paying for your healthcare costs in full before your insurance company will begin paying for a portion of your services. Once you meet your deductible, you will then be responsible for paying the copay amount determined by your insurance company.

A superbill is essentially a detailed receipt for therapy services provided to you that you privately paid for. Superbills can be submitted to your insurance company for possible reimbursement for these out-of-network therapy sessions. Typically, a superbill contains your provider’s information, your name, the dates of service, CPT code, description, ICD-10 codes, the amount you paid per session, as well as the total amount you paid for the services provided.

These acronyms refer to different types of insurance plans. Each of these plans offer different benefits. If you are unsure which insurance plan you have, you can contact your insurance company to learn more about your plan and benefits.

To learn more about HMO, EPO, PPO, and POS plans and the differences between these plans, check out this helpful article.

A Current Procedural Terminology (CPT) code is a numerical code used by providers and insurance companies to describe the services that have been provided to you and the reimbursement rate for those services. CPT codes that I most frequently use include 90791 (diagnostic evaluation) for first sessions, 90837 (60 minute psychotherapy session) for most ongoing therapy sessions, 90834 (45 minute psychotherapy session) for shorter sessions, and 90847 (family or conjoint session) for relationship and family therapy sessions.

Each mental health diagnosis has its own International Classification of Diseases, Tenth Revision (ICD-10) code. The ICD-10 code is what frequently appears on insurance billing documents, including superbills. For mental health diagnoses, this code typically starts with the letter F and includes numbers and occasionally a period symbol.

Sliding scale opportunities for private pay clients are intended for those for whom paying the full private pay fee is not financially possible and who would otherwise have difficulty accessing ongoing therapy support.

I offer sliding scale opportunities as part of my commitment to intersectional social justice. I ask that you engage in heartfelt and justice-oriented self-reflection around your access to financial resources in considering whether a sliding scale fee request feels right for you to ensure there are sliding scale opportunities available for those who need them.

For those in genuine need of sliding scale fees, please do not hesitate to request a sliding scale fee!

I do not have set sliding scale fees, rather I ask for those in need of sliding scale to consider what fee feels accessible to you while taking into account the value of our shared labor in the therapy process.

If I am not able to accommodate the fee that is accessible to you, I will provide you with referrals for other sliding scale therapy options.

Absolutely! Depending on your insurance plan, the amount of reimbursement may fluctuate depending upon the amount that you are paying for your therapy sessions.

If you are interested in out-of-network insurance billing, I encourage you to contact your insurance company to explore your out-of-network coverage for mental or behavioral health care before beginning therapy as the availability and amount of reimbursement is determined by your specific insurance plan. Please see “How does out-of-network insurance billing work?” for more information about this process.

For both in-network and out-of-network insurance billing, this depends on your insurance plan and whether or not this is a covered service. To find out whether your insurance plan covers or provides reimbursement for relationship or family therapy, I encourage you to contact your insurance company and ask if your plan covers the 90847 CPT code.

Additionally, to use insurance for relationship or family therapy, the services must meet the criteria for medical necessity. This means that the person whose insurance is being used must qualify for a mental health diagnosis and the content of the therapy must be related to that diagnosis. Growth-oriented reasons for seeking relationship or family therapy, such as improving communication, building trust, etc. unfortunately do not qualify as medical necessity without a mental health diagnosis.

In short, because becoming a therapist, staying a therapist, running a business, and sustaining a therapy practice requires significant resource investments. This includes university degrees, initial and ongoing licensure fees and time investment, continuing education, certifications and trainings, professional consultation services – lawyers, accountants, and fellow therapists, office space and equipment, billing services, secure electronic health record management, liability insurance, taxes, self-employment costs, administrative responsibilities (notetaking, etc.) and tending to our own wellbeing so that we can hold space for others, to name a few.

I dream of a world where the crushing weight of capitalism is lifted off all our backs and access to therapy does not require such a financial investment for all parties involved. In the meantime, I do what I can to support accessible healing opportunities and work towards building a more just and sustainable future for us all.

Conjoint therapy sessions involve added labor in holding space for and navigating the needs and desires of multiple people. Conjoint therapy also involves additional experience, training, and resources to support effectively.

I currently only work with third-party insurance billing organizations (Alma and Headway) and am therefore limited to the insurance partnerships offered by these organizations. I am also mindful of the limitations of certain insurance contracts and am intentional about partnering with those that support my work as a provider, as well as access to care for their members.

I may, depending on what is offered by the billing organizations I work with (Alma and Headway) and the quality of the insurance contracts.

If I do start taking more insurance, I will update my website to reflect my current insurance partnerships.