Out-of-network benefits allow you to work with a provider who doesn't have a contract with your insurance company. Rather than your insurance paying the provider directly, you pay for each session yourself and then submit a claim to be reimbursed. It's a wonderful option for anyone who wants to work with a specialist—whether that means a therapist trained in Internal Family Systems (IFS), someone with deep experience in depression and anxiety, or simply the person who feels like the best fit for where you are in your journey.

My standard session fee is $190. After each session, I'll provide you with a superbill—an itemized receipt that includes the diagnosis and billing codes your insurance needs—so you can submit it directly to your insurer for reimbursement. I try to make this part as easy as possible for you.

It depends on your plan, but here's a gentle place to start:

Check your plan first. Pull out your insurance policy and look for the mental health or behavioral health section. You're looking for phrases like “out-of-network reimbursement,” “deductible,” and “coinsurance.” If you have a PPO, you’re likely in good shape—HMO plans typically don’t include out-of-network benefits, though it’s always worth confirming.

Deductible — The amount you pay entirely on your own before insurance begins contributing. Until you’ve reached this number, you’ll pay the full session fee out of pocket. Important: your deductible resets every year, typically on January 1st (or on your plan’s anniversary date). If you’ve already met some of your deductible earlier in the year, that progress carries forward for the rest of that plan year.

Coinsurance — Your share of the cost after your deductible has been met. If your plan covers 70%, your coinsurance is the remaining 30%.

Allowed Amount — The maximum dollar figure your insurance uses to calculate reimbursement. This is often lower than your therapist’s actual fee, and the difference is yours to cover—but it’s more predictable than it sounds.

CPT codes—Current Procedural Terminology codes—are standardized codes used by all insurance companies to identify specific healthcare services. CPT code 90837 is the code for an individual psychotherapy session of 53 minutes or more.)

Superbill - A detailed receipt your therapist provides after each session. It includes your diagnosis code, the CPT billing code for the service, the date of service, and provider information. You submit this directly to your insurance company to request reimbursement. It’s different from a standard receipt—it contains the clinical and billing information insurers require to process a claim.

The member services number on the back of your insurance card is the best place to start. It can feel like a lot, but you really only need to ask four things:

1. Do I have out-of-network benefits for outpatient mental health care?

2. Is there a deductible I need to meet first, and how much of it have I already met this year?

3. What is the allowed amount for CPT code 90837, and what percentage will my plan reimburse? That percentage is what you’ll actually receive back.

4. Are there any session limits or prior authorization requirements?

Numbers can feel abstract, so here’s a concrete example to bring it to life:

• Session fee: $190

• Your plan reimburses 70% of the allowed amount, after a $1,000 deductible

• Allowed amount for code 90837: $150 (this is an example, your insurance company will tell you the allowable dollar amount during your call)

You pay $190 per session and receive a superbill after each one to submit to your insurance. Your insurer tracks the allowed amount ($150) from each visit against your deductible. Once you’ve reached that $1,000 threshold—around 7 sessions—your insurance begins reimbursing $105 per session, and your effective cost drops to $85.

A Note on the Allowed Amount Gap

If your insurer’s allowed amount is $150 and the session fee is $190, the $40 difference won’t be reimbursed and doesn’t count toward your deductible. This is standard practice with out-of-network providers—and once you know to expect it, it’s much easier to plan around.

I believe that cost shouldn’t be the thing standing between you and the support you need. A limited number of sliding scale spots are available for clients who qualify, and this is always a conversation I’m glad to have. Please don’t hesitate to reach out—we’ll find a way forward together.