Insurance Information: Reimbursement Rates
Insurance: Most insurance companies will reimburse you for our services rendered at our Society Hill Therapy office location and our Art Museum / Fairmount office location. Insurance companies typically do not reimburse for telephone counseling. Prior to starting treatment, we encourage you to call them to determine the exact amount your insurance company will reimburse you. In addition, many clients use their Medical Service Account or their Flexible Spending Account to pay for services.
If finances are an issue, and you are not using your insurance, consider working with one of our Interns or Fellows. Their fees are significantly lower, and all of their work is overseen by our senior staff. Interns are students in a masters degree program. Fellows are clinician’s who already have a masters or doctoral degree, but are seeking specialized training from us.
Common Questions to ask your insurance company:
- What is the reimbursement rate for an out-of-network provider?
- Do I have a deductible? And if so, how much is it?
- Do I need approval from my primary care provider?
- How many sessions per year do I have coverage for?
- What form(s) do I need to submit so that I can be reimbursed?
To help you navigate the world of insurance, we have created a “Cheat Sheet” of what to say.
When you speak with your insurance company, tell them that you are seeing an “out-of-network-therapist” and ask them what the “reimbursement rate” is for each session.
To help you determine the reimbursement rate, we have listed some common codes. You will need to provide your insurance company with one procedure code, one diagnostic code, the length of the session and the actual cost of the session.
The length of Therapy Sessions:
- 53 minutes Long
- 90837 Individual Counseling
- 90847 Family Counseling (this includes couples counseling)
- 90853 Group Therapy
- F43.21 Adjustment Disorder with Depressed Mood
- F43.22 Adjustment Disorder with Anxiety
- F41.0 Panic Disorder
- F41.1 Generalized Anxiety Disorder
- F42 Obsessive Compulsive Disorder
- F43.10 Posttraumatic Stress Disorder
- F91.3 Oppositional Defiant Disorder
- F50.2 Bulimia Nervosa Disorder
- F50.01 Anorexia Nervosa
- F34.1 Dysthymia
- F34.8 Disruptive Mood Dysregulation
- F31.11 Bipolar
- F60.3 Borderline Personality Disorder
- F60.81 Narcissistic Disorder
- F60.7 Dependent Personality Disorder
- F52.32 Delayed Ejaculation
- F52.21 Erectile Disorder
- F52.31 Orgasm Disorder
- F52.22 Female Desire Disorder
- F65.3 Voyeuristic Disorder
- There are many more codes that we use, but this should be enough to determine your out-of-network rate for mental health counseling.
WE ARE OUT OF NETWORK PROVIDERS FOR THE FOLLOWING INSURANCE COMPANIES
- Anthem Blue Cross
- Blue Cross/ Blue Shield
- Highmark Premier Blue Shield
- Horizon Blue Cross
- Independence Blue Cross
- Keystone Health Plan East
- Kaiser Permanente
- Magellan Behavioral Health
- Penn Behavioral Health
- Personal Choice
- Tri-Care PPO
- United Behavioral Health / Optum
- Value Options
If you wish further assistance in this process we are happy to have a three-way conversation with you and your insurance company. Just call 215-922-5683 option 1 and speak with a therapist, or call Alex Robboy at 267-324-9564