What to Ask Your Insurance company to Figure Out If You Are Covered and For How Much: 

Look on the back of your insurance card for the Member Services number. When you call, make a note of the name, date, and time of the representative to whom you are speaking. Ask the following questions:

1. Does my plan include “out-of-network” coverage for outpatient mental health? (If not, you would be responsible for the full fee and there is no need to ask the representative any other questions.)
2. Is there an annual deductible for out-of-network mental health benefits? (Your annual deductible is the amount you need to hit before your insurance company can start reimbursing for your sessions.)
3. If so, how much? And how much have I already met of it?
4. Is there a limit on the number of sessions your plan will cover per year? If yes, how many?
5. Is there a limit on out of pocket expenses per year?
6. What is my co-insurance percentage for mental health services?
7. Does my plan require pre-authorization for psychotherapy?
8. What is the policy year (i.e. Jan 1 – Dec 31)?

   9. What do you pay for a Masters level provider using service code 90791 (the first visit, a 60 minute, integrated        biopsychosocial assessment, including history, mental status, and recommendations). (I charge $175)
​  10. What do you pay for a Masters level provider using service code 90834  (a 45-minute psychotherapy session). 
  (I charge $150)
​  11. When my provider gives me a “superbill” (which is a document that outlines the services you received from a        provider) how and where do I submit my claim in order to receive reimbursement? 

If you have any questions, please let me know ---> Dayna 908-907-3636



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