Private-Pay Policy

As the owner of a private-pay practice, I do not file insurance claims on behalf of my clients.

However, your insurance plan may offer "Out-of-Network" benefits that could provide partial reimbursement for your session fee, paid directly to you. Click on "Can I Use My Out-of-Network Benefits" below to access a helpful Tip Sheet designed to guide you through a comprehensive conversation with your insurance representative. 

I enjoy working with seniors in both individual and couples therapy. Many of my senior clients bring an eagerness and openness to learning new or better ways to navigate the challenges of aging and live with greater well-being. 

As part of a business decision, I chose not to participate in any insurance plans, including Medicare and Medicare Supplemental plans.

However, Medicare has created a process that allows clients to self-pay for mental health services. This involves a simple, one-page "Opt-Out" form. By signing it, you acknowledge your decision to work with me as an out-of-network provider and to self-pay for services. I am required to keep this form in my records, and Medicare may request it as evidence of your voluntary choice. 

You may not know that, in late 2024, Medicare expanded its mental health coverage to include a wider range of providers. This change gives Medicare-insured clients greater access to care by adding new categories of professionals: 

• Psychiatrists or other doctors (MD, DO)
• Clinical psychologists (PhD, PsyD)
• Clinical social workers (LSW, LCSW, etc.) added 2024
• Clinical nurse specialists (BSN, MSN specializing in mental health)
• Nurse practitioners (NP, ANP)
• Physician assistants (PA)
• Marriage & family therapists (MFT) added 2024
• Mental health counselors (LPC, LCPC) added 2024

These updates mean that Licensed Professional Counselors like myself are now officially recognized by Medicare, offering more flexibility and options for those seeking care.

Most insurance policies today include a mental health benefit. Depending on your current health insurance provider or employee benefit plan, your sessions may be covered in full or in part. 

When deciding between using insurance or paying fee-for-service, it’s important to understand that all insurance companies require a mental health diagnosis in order to pay for services. This diagnosis will become a permanent part of your health record.

If your policy includes out-of-network benefits, we can still work together. You may be able to submit for reimbursement directly from your insurance company for the fee you paid to me. In many cases, the reimbursement you receive can be greater than the amount your insurance would pay an in-network provider.

For more information, click on the questions below:

• What Questions Should I Ask My Insurance Company Representative?
• What is a Superbill?

Tips-for-Using-Your-Out-of-Network-Benefits.pdf 

If you would like to use your insurance benefits, I encourage you to contact your insurance company directly to verify how your plan reimburses for psychotherapy services.

The Tips for Using Your Out-of-Network Benefits guide (below) can help you navigate this conversation with your insurance carrier’s benefits representative.

If your plan includes out-of-network benefits and you wish to use them, please let me know. I will provide you with a detailed statement called a “Superbill.” This document includes:

- 5-digit billing codes

- Dates of service

- The amount you paid

- A diagnosis code

- Other information required by your insurance company

You will then submit the Superbill to your insurance company according to the filing procedure they outline during your benefits call.

Tips-for-Using-Your-Out-of-Network-Benefits.pdf 

If you would like to use your insurance benefits, I encourage you to contact your insurance company directly to verify how your plan reimburses for psychotherapy services.

Using the "Tips for Using Your Out-of-Network Benefits" guide can help you navigate this conversation with your insurance carrier’s benefits representative.

If your plan includes out-of-network benefits and you wish to use them, please let me know. I will provide you with a detailed statement called a “Superbill.”

Self-Pay Policy - As a self-pay practice owner, I do not file insurance claim forms for my clients.

If you wish to use your insurance benefits for reimbursement, you may submit a Superbill to your insurance company. Any reimbursement will be sent directly to you by your insurance company.

What Is a Superbill? A Superbill is a detailed invoice that contains all the information your insurance carrier needs to process your claim for reimbursement.

• You can access the “Tips for Using Your Out-of-Network Benefits” form under “What Questions Should I Ask My Insurance Representative?” for guidance when contacting your insurance company.
• How to Request a Superbill - If you decide to seek reimbursement:
  • Contact me so I can make the Superbill available through your Client Portal.
  • Inform me if your insurance carrier requires a signed Superbill.
• Submit the Superbill to your insurance company using their established filing process.

What Information Is Included in a Superbill?

• Therapist information: credentials, contact numbers, and practice address
• Client information: full legal name, date of birth, address, and phone number
• Service details: date(s) of service, type of therapy (individual, couples, family), session length, and any modifier codes
  • Session fee charged
  • CPT Code(s): identifies the session type (e.g., 90834 for a 45-minute individual session)
  • ICD-10 Code: your clinical diagnosis
  • Deductible details: self-pay services will not be reimbursed until your deductible is met. Filing a Superbill ensures your payments may count toward your deductible.
  • Co-pay information: your co-pay requirements may also impact your reimbursement amount.

Important Tips

• Track your submissions: Keep a record of what you submitted, when, where, and how.
• Review your EOBs: Check your Explanation of Benefits (EOB) statements to ensure accuracy.
• Be patient: Reimbursement can be a slow process, so allow time for your insurance company to review your claim.

If you are unable to attend a scheduled session, please cancel at least 24 hours in advance. Cancellations made with less than 24 hours' notice—or missed appointments—may result in being charged the full session fee as a "Missed Appointment Fee." This fee may be charged to the payment source on file in the Electronic Health Record system used by my practice.

Cancellation & Missed Appointment Policy

If you are unable to attend a scheduled session, please cancel at least 24 hours in advance. Cancellations made with less than 24 hours’ notice—or missed appointments—may result in being charged the full session fee as a "Missed Appointment Fee." This fee will be charged to the payment source on file in the Electronic Health Record system used by my practice.

Important Notes About Payment

• Health Savings Accounts (HSA), Flexible Spending Accounts (FSA), and Health Reimbursement Accounts (HRA): These cards generally do not cover missed appointment fees. Please check with your card provider before attempting to file for reimbursement.

• Insurance Reimbursement: Missed appointment fees are not reimbursable by insurance and cannot be included on a Superbill.

Health Savings Accounts (HSA), Flexible Spending Accounts (FSA), and Health Reimbursement Accounts (HRA): typically do not cover missed appointment fees. It’s important to check with your card provider before filing for reimbursement. 

Insurance Reimbursement: Additionally, insurance reimbursement does not cover missed appointment fees, and such fees cannot be included on a Superbill.