Do you take insurance?

Your insurance questions answered

The process of deciding to reach out and get the support you need is deeply personal and private.  Having the financial means within your budget is another step to making it happen.

Connecticare and United Healthcare

I'm a participating provider or "in-network provider,"  for Connecticare and United Healthcare. In the spirit of tranparency, it's not a guarantee my services are covered.

There are a lot of different types of plans within these companies.  To find out, in general, if your plan-policy covers behavioral health-mental health, please check with CareFirst Maryland directly to see if mental health services (behavioral health) are covered for individual psychotherapy and group psychotherapy. This means calling customer service number on the back of your card or log into the directory online to check your policy.

To help with that, scroll down this page for the codes used for reimbursement.  Use them to refer to when you speak with customer care or when logging in online.

Additionally, no matter what a customer service rep shares with you or me, we don't know if your plan covers services.  A claim has to be filed for your session and it is only then, after filing, you and I see if your services are covered.  This is generally known within 3 weeks +/- 1 week.

So if you have ConnecticutCare or United Healthcare health insurance, your insurance company will be billed directly, provided you are actively covered.

Benefits Disclaimer: Please know that checking for your Eligibility and Benefits, checks are only an estimate provided by the insurance company and you may see differences from what was reported. Also, it is not a guarantee of payment. Benefits are subject to all contract limits and the member's status on the date of service. Accumulated amounts such as deductible or copay may change as additional claims are processed.

If you are not with ConnecticutCare or United Healthcare you will be billed the full rate at your appointment and given a superbill as a receipt (unless another arrangement was discussed). You can submit the superbill to your insurance provider directly. Read on for more info about superbills.

Out of network options: Superbills

I'm an out-of-network provider with all other insurance companies.

Regardless, mental health services may be reimbursable by your plan. For example, if you have “out-of-network” services on your plan, like on a PPO, then psychotherapy and counseling are most probably covered.

Call your customer care number and use the codes below to see if you have out of network benefits for the codes that apply to psychotherapy and counseling. It's also called behavioral health.

A superbill can be provided for your sessions. You then submit your superbill to seek reimbursement from your insurance company.  Superbills are essentially your receipt of attending and paying for a session along with the required billing codes.

Out-of-network options: HSA & FSA

If you're unable to get reimbursed for out of network services, then you may still have other options.

Some clients use their Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for psychotherapy and counseling.

What is a health savings account? What is a flexible spending account? The details of these questions are outside my area of expertise.  I recommend that you learn more about them by doing some research and speaking to a qualified financial expert.

I hope this page has offered some help in providing answers and clarity.  Money and the ability to pay can be a barrier to getting the help you need if you let it. It doesn’t have to be. There are counseling resources available for every budget. Let me know if I can answer further questions.

Ask about these billing codes (aka CPT codes):

The following billing codes apply to services offered here.  All of these codes will likely not apply to you. That said, it's good to check to see what is covered so you know your options. In this way, you can make an educated and informed decision.

Also, by checking on these codes you erase any potential financial surprises. And you can enter into therapy to do your inner work with less stress.

• 90791 for initial consultation and diagnostic evaluation
• 90837 Individual psychotherapy
• 90837-95 Individual psychotherapy, interactive, real-time, synchronous telemental health session (video).
  
• 99354 Companion code
• 99354-95 Companion code, interactive, real-time, synchronous telemental health session (video).
• 99355 Companion code
• 90853 Group psychotherapy
  

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Lucrezia Mangione is a board certified licensed professional counselor, board certified telemental health provider, neurofeedback trainer, sensitive coach, and approved counselor supervisor. View her profile. She is the owner of Mind Body Well Therapy, Pllc.