Some, but not all clients have health insurance that might fully or partially reimburse payments made to an out-of-network provider. I am considered an out-of-network provider because I do not accept insurance directly. Instead, I support clients who have out-of-network benefits in taking the steps to get reimbursed.
Here is how it typically works: the client pays for services out-of-pocket, and the therapist provides a monthly “superbill” that the client submits online or by mail; the insurance company then sends a check to the client for the amount reimbursed.
Different insurance companies have different policies about whether and how much they reimburse, and whether they cover in-person services, telepsychology, or both. Here are the steps that you can take to determine whether your health insurance company will cover psychotherapy with an out-of-network provider.
First, contact the telephone number on the back of your insurance card. Have a pen and paper or device ready to take notes. Ask them the following questions:
- Is telepsychotherapy with an out-of-network provider (CPT code 90834-95) covered by my plan?
- How many sessions do you cover in a year?
- Would I need to pay a deductible before you start covering sessions?
- What percentage of the fee do you cover?
- Is my provider’s fee within the range of what you use to determine reimbursement? (And if not, what is your range?)
They might ask for information about your provider. My full name is Dr. Sarah Kamens; I am a licensed psychologist with a PhD in Clinical Psychology. My NPI # is 1669109096. I am a licensed in New York (#23326) and in Kansas (#LP03142). I am a certified PSYPACT provider in 35+ other states/areas (APIT #13487; see my list of telehealth locations here). My mailing address for New York clients is: 220 Fifth Ave., 11th Floor, New York, NY 10001. My mailing address for clients in all other states is: 11900 College Blvd., Suite 310, Overland Park, KS 66210
Please feel free to contact me with any questions or concerns that you might have. I am dedicated supporting clients through this process.