Questions to ask insurance providers when pursuing out-of-network reimbursement

  • Do I have out-of-network coverage for mental health (or behavioral health)?

  • use CPT Code 90834 (for individual)

  • use CPT Code 90847 (for Couples)

  • Do you cover Licensed Creative Arts Therapy?

  • What is my deductible and how much has already been met?

  • What is my out of pocket payment before my deductible is met?

  • What percentage of the fee for each visit will be covered?

  • How many mental health sessions per calendar year does my insurance plan cover?

  • How do I obtain reimbursement for therapy with an out-of-network provider?

  • Is approval required from my primary care physician.