top of page
colorfultree.jpg

Insurance and Fees

I accept United Health Care,  Blue Cross Blue Shields, Aetna, Health care highway, Cigna and Healthchoice.  Insurance covers individual therapy and usually also couples enrichment. This page will tell you what you need to know about your insurance.  It's best to be familiar with your own plan, so you have no surprise costs.

Billing Insurance

In order to use your insurance, you have to meet a mental diagnosis  (deemed medically necessary), which is described in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5)  If you're curious about the list of psychological billable diagnoses.  We can discuss this in our first session. 

I accept insurance as I know therapy is essential for everyone. 

 

I've heard some misinformation about insurance, listed below addresses the 2 main ones

Most insurance companies do NOT limit the number of sessions and if you have received medication from a doctor for mental health, then you have a diagnosis code on your file (just let me know). The Affordable Care Act (ACA) made it illegal for insurance companies to refuse coverage for a pre-existing condition like depression, along with many other kinds of pre-existing conditions.  

This law applies to health plans that continue to follow ACA guidelines. ACA plans cannot charge you more or raise your rates just because you have been diagnosed, have received, or are currently receiving treatment for depression (etc). As the political landscape shifts, there could be new health plans made available that do not follow ACA standards. Please check your policy. BCBS of Oklahoma states Beginning Jan.1, 2014, individuals cannot be denied coverage because of a pre-existing condition. ACA protects these individuals from having to pay higher rates or have benefits limited to exclude these conditions. United Health Cares has a similar statement on their website

NOTE:  if you are using your insurance for couples enrichment counseling, one person needs to be billed with the DSM-5 diagnosable medical appropriate diagnosis. See the link above for the list of mental disorders (I will also assess in our first session), but if neither of you qualifies for a medically appropriate DSM-5 condition the cost is $125 a session, as insurance is based on a medical model. 

What to ask your insurance:

To determine if you have mental health coverage through your insurance carrier, the first thing you should do is call them. Ask (1) Do I have to meet my deductible before my benefits (your copay) goes into effect for behavioral health? (2) What is your deductible? (3) What is your co-pay for outpatient therapy online and office?  I know medical offices or group counseling offices hire staff to do insurance eligibility, but as a solo provider, I cut my costs by having you call the customer service number on the back of your card. Thank you.

Cost with insurance

If you have insurance, the cost will vary depending on your plan.  You may still have to pay your insurance contracted rate (the insurance company sets the session fee usually $70-125) because most plans require you to meet your deductible before your benefits will be applied.  Then the copay amount will be based on your plan.  On average the copay is about $20-40   after the deductible- if that needs to be met first.   

Private Pay Fee

50-60 minute individual: $90 a session

90 minutes enrichment couples class: $100 a session 

75-minute session for couples therapy: $125 (offered after taking the enrichment couples class)

I offer a reasonable fee on purpose (the average fee 50-minute session is $125-$225 a session) for private practice.   I do offer two spots for sliding scale on a bi-weekly basis (AM/Afternoon hours, sorry not evenings times) for a total of 9 months.  My sliding scale fee is $45 a session.   

  

bottom of page