1. Protect your privacy. When you use insurance benefits to pay for services, your records can become accessible to the insurance company. They can request the entire record, copies of notes, a summary of treatment--essentially, as much or as little as they want. They do so to ensure that the services they are paying for are medically necessary and meet requirements for coverage. They also require therapists to provide a mental health diagnosis. The information in this paragraph is true of both in-network and out-of-network use of benefits (e.g., Superbills).

Some people prefer to have more privacy. By not billing insurance, clinical information (including diagnoses, services, notes) is kept solely within the therapist's practice. Some feel more comfortable knowing that their private information is, in fact, being kept private.

Additionally, therapy is not one-size-fits-all, and some people seek therapy for reasons that do not fit perfectly into the boxes set forth as "necessary" by insurance companies. For example, there are many people who come to therapy who do not meet diagnostic criteria for a disorder, or who want to use the therapeutic space more freely.

2. More freedom over treatment. When paying out of pocket (private pay), decisions about your treatment are made mutually between you and your therapist.  Insurance companies often follow their own standardized approach to treatment, allowing for only specific session structures, authorizing a certain number of sessions, or holding clients to specific timelines. By not billing through insurance, you and your therapist are free to co-create a treatment plan that is helpful to you and your concerns. This means collaborating together to decide how long you stay in therapy and what therapy entails, without pressures from an insurance company trying to make these decisions.

3. Find therapists more easily. It can be difficult finding a therapist who takes your insurance, and even harder finding one who takes your insurance and has availability. By paying out of pocket, more options tend to be available.

In-Network Questions:

1. Do I have "in-network" benefits for psychotherapy (telehealth)?

2. What is my "in-network" deductible and has it been met?

3. What percentage of the fee is covered once I meet my plan's deductible?

4. What can I expect my co-payment to be?

5. Is there a limit to how many sessions my plan will cover this year?

6. Is approval required from my primary care physician?

Out-of-Network Questions:

1. Do I have "out-of-network" benefits for psychotherapy (telehealth)?

2. What is my "out-of-network" deductible and has it been met?

3. What percentage of the fee is covered once I meet my plan's deductible?

4. Is there a limit to how many sessions my plan will cover this year?

5. What is the process for submitting a "Superbill" and receiving reimbursement?

6. Is approval required from my primary care physician?

CPT Codes for services are as follows:

• 90791- Initial Assessment

• 90834- 45 min therapy follow-up session

• 90837- 60 min therapy follow-up session

A Superbill is a special type of invoice that lists services you have received from an out-of-network provider.

How it works: You would pay me the full session fee at the time of each session. Then, on a monthly basis, I would complete a Superbill that reflects our sessions for that month. You would then submit that form to your insurance company, and they will decide if they will cover a percentage of the session fee. I recommend asking your insurance company about “out of network” mental health (telehealth) coverage prior to scheduling an initial intake appointment.

I ask for 24 hour notice to reschedule an appointment without charge. I charge my full session fee for appointments cancelled within 24 hours. Clients who use insurance will be charged the full amount insurance would have reimbursed for the session. 

Clients must be physically located in the state of Massachusetts at the time of their telehealth session.