Questions you can ask your insurance company to gather information about your out of network (OON) coverage:
Do I have out of network benefits?
How much of the fee will I be reimbursed for each individual psychotherapy session with an out-of-network provider?
The CPT code is 90791 for an assessment session; my fee is $195/session. The CPT code is 90837 for a 53-minute individual therapy session; my fee is $175/session. The CPT code is 90834 for a 45-minute individual therapy session; my fee is $150/session.
How much of the fee will I be reimbursed for each group psychotherapy session with an out-of-network provider?
The CPT code is 90853 for a group therapy session; my fee is $50 per group.
What is my out-of-network deductible and how much of it has already been met?
The deductible is how much money you have to spend per plan year before your insurance benefits kick in and start reimbursing you. Some plans have this and some don't.
What is my out of network out of pocket maximum?
The out-of-pocket maximum is the maximum amount you'll spend per plan year on covered, out-of-network medical expenses before your insurance will cover 100% of the costs. Some plans have this and some don't.