SESSION RATES AND BENEFITS ACCEPTED
Below you'll find session rates and which benefits are accepted for each therapist.

INSURANCE

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One of our top values is accessibility to care, which is why we accept BCBS and Aetna (including the NC State health plan). Unfortunately, insurance coverage for mental health can be tricky, frustrating and confusing to most of us, so we want to try to help make sure you are prepared and understand your coverage as best possible prior to starting your counseling journey so there aren’t surprises that arise. 

 

Every plan can be so different from the next, especially regarding mental health coverage, which is why we require you reach out to your plan (the number on the back of your insurance card) to inquire about your mental health benefits. We also ALWAYS recommend that when you call you get the name and reference number of the call to refer back to in case something goes unexpectedly with your coverage. 

 

Here is how you approach your health insurance company to explore your benefits and coverage before your first session:

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First, call the number on the back of your card to inquire about your coverage. When you get a representative on the line, tell them you are inquiring about your mental health benefits and coverage for an outpatient, office setting.

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Next, you will need to provide your full name, subscribe/member number, and your DOB.  You may also need to provide our National Provider Identification Number (NPI#): 

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Type I (individual) #: 1487163762 

Type 2 (group) #: 1821606757

 

There are a few options your representative may discuss with you. If you have mental health coverage, they will discuss how they work, using words like copays or coinsurance, or deductibles.

 

Co-pays or coinsurance: Your coverage may reimburse you for all or part of your session fees, depending on your plan. A copay is the same amount for each session, which you are required to pay (example $10, $25 or $50) and your plan will cover the rest of their contracted amount to your provider. A coinsurance is a percentage that you are responsible for paying, typically after you hit your deductible, and then your insurance plan will pay the rest (example you pay 10%, they pay 90%). 

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Deductibles: If you have a deductible to meet (varies across plans), then the representative will inform you of the amount of the deductible for your plan and the amount you have already paid towards the deductible, if applicable. Make sure to ask if the deductible starts over each calendar year (most typical) or if not, what date it starts over. The representative should also be able to tell you the maximum amount you are responsible for paying, (which is set by the insurance company, not us!) which is less than our self pay rate. 

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CPT codes: There are different codes for different services that the insurance company will reimburse. These codes may need to be provided to ask about what your coverage will support you with. The most used codes for individual, outpatient mental health counseling in an office setting are:

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90791-Intake (45-60 min)
90837-Individual therapy (53+min)

 

Lastly, inquire if your coverage for these codes requires prior authorization before receiving services.

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If you have more questions please feel free to call us and we can continue to support you with your health insurance coverage, as best we can!