Greater Freedom in Choosing Your Therapist: Private pay lets you choose the therapist who best meets your needs, rather than being limited to in-network options. This is particularly helpful if you’re seeking specialized expertise or services not typically covered by insurance, like sex therapy or partnered therapy.

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Tailored, Unrestricted Care: Insurance often limits session length, frequency, and coverage. With private pay, you and your therapist can create a custom plan without restrictions or arbitrary limits.

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Improved Confidentiality: Insurance requires detailed treatment notes and diagnoses, which can compromise your privacy. As I see many folks from marginalized groups the expectation to document identities is not aligned with protections I want to offer. Private pay ensures your personal information stays between you and your therapist.

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Access to Specialized Care: Many out-of-network therapists offer advanced, specialized services, such as holistic mental health care, expert couples therapy, or targeted support for sex therapy, giving you high-quality care not always available in-network.

If you choose to see an out-of-network therapist, you may still be eligible for partial reimbursement from your insurance company through a process called superbilling. A superbill is a detailed invoice your therapist provides at the end of each month.

You will pay your therapist directly for each session at the time of service. After you are charged, you will be automatically sent a details bill through Sessions Health which includes all the information insurance companies need. Depending on your out-of-network benefits, your insurance company may reimburse you for 50-80% of the session cost. Please contact your insurance company prior to using out-of-network benefits.

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Superbilling can be a great way to blend the flexibility of private pay with the financial help of insurance. Project Passion Therapy uses Mentaya - a service that submits superbills on your behalf to make getting reimbursed a headache-free process. Please inquire for more information. 

Before starting with an out-of-network therapist, contact your insurance company and ask these key questions to understand your coverage and potential reimbursement:

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1. Do I have out-of-network benefits for mental health services?

2. Do these benefits cover the following codes:

90837: Individual Psychotherapy, 53 minutes with patient

90847: Family Psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes

3. Do I have a deductible that needs to be met prior to me receiving reimbursement for out-of-network services? If yes, what is my deductible, and how much has already been met?

4. After my deductible is met, how much will I be reimbursed per session? (Individual Sessions: $175, Partnered Sessions: $200)

5. Are there limits on how many therapy sessions I can be reimbursed for each year?

6. How long does it typically take to receive reimbursement once I submit a superbill?

7. What is the process for submitting a superbill (e.g., online, by mail)?

8. Is pre-authorization needed for out-of-network mental health services?

By asking these questions, you’ll have a clear understanding of your benefits and how to maximize them.