Many clients are unsure what “out-of-network” therapy means or how reimbursement works. This page explains the process step by step so you know what to expect before scheduling.
What does “out-of-network” mean?
Being out-of-network means I do not have a contract with your insurance company.
Instead of billing insurance directly, you pay for sessions at the time of service. If your insurance plan offers out-of-network mental health benefits, you may be able to request partial reimbursement directly from your insurer.
Some clients prefer out-of-network therapy because it allows for greater privacy, flexibility, and continuity of care.
Do I need insurance to work with you?
No. You do not need insurance to receive therapy services.
If you have insurance, it may or may not reimburse a portion of your session fees depending on your plan. Therapy can also be paid for using self-pay, HSA, or FSA funds.
How does payment work?
Session fees are due at the time of service.
You can pay using credit card, cash, check, or HSA/FSA cards. Receipts are available upon request for all services.
What is a superbill?
A superbill is a detailed receipt that includes the information insurance companies typically require for out-of-network reimbursement.
Upon request, I can provide a superbill that you submit directly to your insurance company. I do not submit claims on your behalf and cannot guarantee reimbursement.
How do I get reimbursed by my insurance company?
If your plan includes out-of-network benefits, the general process looks like this:
- You attend your therapy session and pay the session fee
- You request a superbill from me
- You submit the superbill to your insurance company
- Your insurance company reviews the claim and determines reimbursement
Reimbursement amounts and timelines vary by insurer and plan.
How much will my insurance reimburse?
This depends entirely on your individual insurance plan.
Some plans reimburse a percentage of the session fee after your deductible is met. Others may not cover out-of-network therapy at all. Your insurance company can tell you what to expect before you begin services.
Are virtual therapy sessions covered?
Some insurance plans reimburse virtual therapy at the same rate as in-person sessions, while others do not.
It’s important to ask your insurance company whether telehealth or virtual mental health services are covered under your out-of-network benefits.
What questions should I ask my insurance company?
When calling your insurance provider, you may want to ask:
- Do I have out-of-network mental health benefits with an LCSW?
- What percentage of services is covered?
- Is preauthorization required?
- What is my deductible, and how much has been met?
- How many sessions are covered and within what timeframe?
- Are virtual therapy sessions covered?
- What forms are required for reimbursement, and how do I submit them?
You may be asked to reference the following CPT codes:
- 90791 – Intake / Diagnostic Evaluation
- 90834 – Individual Therapy (38–52 minutes)
- 90837 – Individual Therapy (53–60 minutes)
- 90847 – Couples/Family Therapy
Can you help me check my benefits?
I cannot contact your insurance company on your behalf. However, some clients choose to use a third-party service such as Mentaya, which helps verify out-of-network benefits and answer reimbursement questions.
Why do some therapists choose to be out-of-network?
Many therapists choose out-of-network practice to reduce administrative burden and protect the quality of care.
This model allows for:
- Greater privacy (diagnoses are not required for insurance)
- More flexibility in treatment length and frequency
- Consistency of care without insurance-driven limitations
Is out-of-network therapy right for me?
Out-of-network therapy may be a good fit if you:
- Want more flexibility and privacy
- Have out-of-network benefits or plan to self-pay
- Prefer virtual therapy
- Are comfortable managing reimbursement if applicable
If you’re unsure, you’re welcome to review my Payments & Fees page or reach out through my Contact page with general questions before scheduling.