Insurance & Out-of-Network Billing for NYC Therapy

What does being an "out-of-network" provider mean?

As an out-of-network provider, I do not bill insurance companies directly. However, many plans offer out-of-network benefits that allow you to be reimbursed for a portion of your therapy expenses. If your insurance offers these benefits, I can provide you with a monthly "superbill." This receipt contains all the necessary diagnostic and service coding required by insurance carriers to process your claim for reimbursement.

You should contact your insurance company and ask:

• Does your plan offer “out-of-network” mental health benefits?
• What is your annual deductible and has it been met yet?
• What is the percentage rate for reimbursement once the deductible is met?
• What is the "maximum allowed amount" for procedure codes 90834 (45-minute) or 90837 (60-minute)?
• Do they cover services provided by a New York State Licensed Psychoanalyst?
• Is pre-authorization required before starting treatment?

Why do you choose to be an "out-of-network provider"?

I choose to work as an out-of-network provider to prioritize the quality and confidentiality of your care. This approach allows us to avoid the constraints often imposed by insurance companies, such as mandated treatment plans, frequency requirements, or session limits that may not align with your actual needs.

Furthermore, insurance companies require a formal mental health diagnosis and can audit clinical records to justify treatment. By working out-of-network, I maintain the flexibility to tailor therapy to your unique pace and ensure your treatment history remains strictly confidential between us.