Questions to Ask Your Insurance About Out-of-Network Therapy Reimbursement


When calling your insurance provider, you can ask:

  1. Do I have out-of-network benefits for outpatient mental health services (CPT code 90837 or 90834)?

  2. Do I have a deductible for out-of-network care? If so, how much of it have I met this year?

  3. What percentage of the session fee will be reimbursed after my deductible is met?

  4. Is there a limit to how many sessions are covered per year?

  5. Do I need a referral or prior authorization from my primary care physician?

  6. How do I submit a superbill or claim for reimbursement?

  7. How long does reimbursement typically take?

  8. Will the reimbursement be sent directly to me, or to the provider?