These 6 questions will help determine if your insurance plan will compensate you for all or part of your expenses:
- Do I have “out of network” mental health insurance benefits?
- What is my mental health deductible and has it been met?
- What month does the coverage end or begin?
- What is the maximum allowed amount for CPT code 99213 and for 90836?
- What percentage of the maximum allowed amount is covered?
- Is pre-authorization required?
When speaking to your insurance company, they may ask you for codes (see #4 above).
Please be aware that while seeking psychotherapy does not require a “medical necessity”, seeking compensation from an insurance company does. This means that you must qualify for (and receive) a mental health diagnosis if you would like insurance to cover psychotherapy visits. Your insurance company also may ask for significant personal information about you and your symptoms in order to decide how much treatment you will be compensated for.