Rates and Insurance

Understanding your Out-of-Network Benefits

I'm an out-of-network provider. That means I don't bill your insurance directly, but many PPO plans still reimburse part of what you pay for therapy. Below is a simple breakdown of how it works, your options for using these benefits, and a tool to check your coverage in seconds.

Check Your Benefits Instantly

This free tool shows whether your plan covers out-of-network mental health care, what your deductible looks like, and roughly what you'd get back per session before you book anything.

Session Rates

30 min | $180 | Brief Session | Billed as CPT code 90832

50 min | $300 | Standard Therapy Session | Billed as CPT code 90834

80 min | $450 | Extended Therapy Session | Billed as CPT code 90837

180 min | $900 | Intensive Outpatient Session | Billed as two distinct CPT codes 90837s

Varies and Case-Specific | Psychodiagnostic Assessment Evaluation | Billed as either CPT codes 90791 + 96127 x4 or CPT codes 96130 + 96131

Payment is due at the time of each session. I accept credit/debit, HSA, FSA, and cash/check. Peer-to-peer payment apps, such as Zelle and Venmo, are not accepted as they are not fully HIPAA-compliant.

How Reimbursement Works

Three terms to know:

  • Deductible: what you pay out of pocket before insurance starts reimbursing you. Resets each plan year.

  • Coinsurance: once your deductible is met, the percentage of the fee your insurance covers.

  • Allowed amount: insurance reimburses based on what they consider reasonable, which may be less than my full fee.

Reimbursement isn't guaranteed and varies by plan. Your insurer makes the final call. The tool above is the fastest way to get a real estimate for your plan.

Questions for your insurance provider:

“What is the allowable amount my plan reimburses for a Los Angeles-based doctoral-level clinician (Psy.D./Ph.D.) for CPT code: 90837/90834/90832?” Plans typically reimburse higher amounts for therapy practices set in geographical locations with high-cost-of-living and therapists with advanced degrees, such as Clinical Psychologists in Los Angeles, CA.

“What portion of that cost will I be expected to pay?” You could ask them to walk you through an example based on the fee amount above using your plan’s copay/co-insurance rates.

For intensive sessions ask: "Will my plan reimburse two units of CPT 90837, same provider, same date, with modifier 59 and documentation of two distinct sessions?”

Two Ways to Use Your Benefits

1. Handle it yourself with a Superbill
I provide a monthly superbill - an itemized receipt with your diagnosis code, procedure codes, and my provider info. You submit it to your insurer and get reimbursed directly, usually within a few weeks.

2. Let Thrizer Manage It
I use Thrizer as my payment platform for sessions. If your plan includes out-of-network benefits, Thrizer can also check your estimated benefits, estimate your session cost, and submit eligible out-of-network claims after each session.

  • Your claim submits automatically after every session. No paperwork on your end!

  • If you're eligible for Instant Reimbursement, you can pay an estimated amount upfront instead of my full fee, and Thrizer advances the rest to me.

  • If not eligible, you pay the full session fee and Thrizer tracks your reimbursement (by check or bank deposit) in your account.

Reimbursement is never guaranteed — your insurance plan determines the final outcome after your claim is processed.

Note: Thrizer's app calls this post-deductible amount a "copay" for simplicity. Technically it's coinsurance, since I'm out-of-network - but you'll see "copay" used inside their platform.

Good Faith Estimate (No Surprises Act)

If you're uninsured or choosing not to use insurance, you have the right to a written estimate of expected costs - a Good Faith Estimate - before treatment begins. I'll provide this at least one business day before your first appointment, and you can request an updated one anytime your treatment or fees change.

If you're billed $400 or more above your estimate, you can dispute the bill through the U.S. Department of Health & Human Services. Learn more at cms.gov/nosurprises or call 1-800-985-3059.

Frequently Asked Questions

Do you offer a sliding scale?
Yes - for a limited number of appointments, based on financial need and availability.

Do you accept insurance directly?
No. I'm out-of-network. Most clients with PPO plans get partial reimbursement through their out-of-network benefits.

How do I find out what my plan covers?
Use the benefit-check tool above, or call the member services number on your insurance card and ask about "out-of-network outpatient mental health benefits."

Is reimbursement guaranteed?
No. Your insurer makes the final call on every claim.

What if my claim is denied?
If you're using a superbill on your own, you'll need to follow up with your insurer directly. If you're using Thrizer, you can reach out through your Thrizer account for support with any claims questions.

Can I use HSA/FSA funds?
Yes.

Cancellation Policy

Please remember to cancel or reschedule 24 hours in advance. You will be responsible for the entire fee if cancellation is less than 24 hours. I enforce this policy with compassionate discretion and do consider extraordinary factors and patterns of session adherence.

Ready to Get Started?

Questions about your plan or how any of this works? I'm happy to walk through it during a free 30-minute consultation.