Out-of-Network Insurance Benefits
Understanding Your Reimbursement Options
Lisa Santiago, LPC operates as a private pay practice, which means she is not contracted with any insurance companies. However, many clients are able to receive partial reimbursement for therapy sessions through their out-of-network mental health benefits.
This approach gives you full control over your therapy while still allowing you to use your insurance coverage when applicable.
Making the Most of Your Benefits
Once you have this information, you’ll have a clear understanding of how much your insurance may reimburse per session. Lisa will provide the documentation you need for each session, so the process remains as simple and transparent as possible.
Questions to Ask Your Insurance Provider
Before beginning therapy, it’s a good idea to verify your out-of-network coverage. When speaking with your insurance representative, you can ask:
- Do I have out-of-network outpatient mental health coverage?
- Are telehealth sessions included in this coverage?
- Do I need a referral or pre-authorization to use these benefits?
- What is my out-of-network deductible, and how much has been met this year?
- What percentage of outpatient psychotherapy sessions are covered after the deductible?
- How much will I be reimbursed for the following services:
- CPT Code 90791 (Initial Diagnostic Evaluation) – $450
- CPT Code 90837 (Psychotherapy, 60 minutes) – $350
- How do I submit a claim for reimbursement?
- How long does reimbursement typically take?