Using Your Insurance

 

Health insurance plans typically cover couple therapy. Plans cover therapy services if at least one person in the relationship is plans do cover therapy services if at least one person in the relationship is affected enough to meet criteria for a diagnosis such as a reaction to severe stress or a significant change in mood. Insurance companies recognize that therapy is a proven method to provide treatment for many situations in life that affect mental health–including relationships. Your therapist will review these insurance requirements in your first intake session. We find that almost always your insurance can be appropriately billed for therapy services.

 

Contact your insurance company via the number on the back of your card to make sure the therapist you wish to work with and MN Couple Therapy Center are in-network providers. If you will be seeing a pre-licensed therapist, check to see if their supervisor is a provider. If we’re in-network, we will bill your insurance for the services provided. 

 

Each insurance company has negotiated contracts with us to pay a set amount for each type of session. This varies from one company to another, and one plan to another. If you have questions about your actual costs, or concerns about how payment works when you are using your insurance, please call the member services number on the back of your insurance card. They can also inform you about the portion of the fee you will need to pay out of pocket (this varies based on the type of plan you have and your coverage). This might be part of your deductible, or a co-pay or co-insurance amount. Please call your insurance company for these costs prior to starting therapy.

 

If using insurance, we require a copy of your insurance card be uploaded into our electronic medical record before you start therapy. 

 

You must inform us of changes to your insurance, or we will not be able to submit claims correctly. This may lead to a denial of payment. If your insurance company denies payment, the bill becomes your responsibility. In this case you will not be charged more than your insurance company would have paid us.

 

Upon request, you may have fees for all services for which you or a third party (such as your insurance) is billed itemized.

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Private Pay | Cash

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If you have insurance but do not wish to use it (or do not have insurance), you may pay cash. Under Section 2799B-6 of the Public Health Service Act, if you are not enrolled in a health plan or coverage or if you are not seeking to file a claim with your plan, therapists are required to inform you (both orally and in writing) about your right to receive, upon request or at the time of scheduling, a “Good Faith Estimate” of expected charges for services. This will help you assess your potential costs prior to starting therapy. Most of our therapists have a sliding scale based on income for cash fees. Please ask your therapist directly about this. Your therapist will let you know the fees for professional services to you at least 3 days before providing the services if at all possible.

 

How Costs are Determined​

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Insurance reimbursement is typically based on codes which are a measure of the duration of a therapy session. Check with your insurance company to make sure the codes your therapist is planning to use are covered—this varies with different policies and companies. (Private pay fees are typically based on the length of a therapy session also.)

 

Common session types (and the Current Procedural Terminology or CPT code associated with them) are:

 

• Diagnostic Assessment (the first appointment) CPT 90791

• 30 min Individual session CPT 90832

• 45 min Individual session CPT 90834

• 60 min Individual session CPT 90837

• 53+ min Couple or Family session CPT 90847

• Couple/family session without client present (e.g. with partner) CPT 90846

• Crisis psychotherapy session CPT 90839

• Group therapy session CPT 90853

 

At present, our therapists are not accepting MEDICARE or MEDICARE ADVANTAGE plans.

 

For Pre-Marital Counseling (Prepare/Enrich sessions) - inquire about the sliding scale fees, as insurance typically does not cover these.

 

You are responsible for payment for your portion of costs for each session at time of service.

 

Your Billing Provider and Your Protected Health Information:

 

Your therapist uses MN Couple Therapy Center as their billing provider. You will be asked to sign a document that allows payment of medical insurance benefits due to you to be paid to your therapist on your behalf. If you are paying cash, payments will be processed through MN Couple Therapy Center. You will be asked to sign a document that allows MN Couple Therapy Center to access your protected health information as needed to provide billing and claims collections from the insurance companies.

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We treat your protected health information in a way that protects your privacy as mandated by the HIPAA policy you have received or been offered to receive.

 

If you have any questions about our financial or billing policies, please ask your therapist. They can also put you in touch with our billing staff.

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