To make our services accessible, all NPA providers accept payment through insurance plan coverage or self pay options.
Does my health insurance cover psychotherapy services?
All health insurance policies cover mental health services under guidelines that refer to “medically necessary” services. Some insurance companies may carve out their mental health benefits to a managed care company (i.e., Optum is the company that provides mental health benefits for Harvard Pilgrim HealthCare).
Insurance will typically provide coverage for face-to-face sessions with a licensed clinician for a diagnosable mental health problem. Your policy will specify how much the company will pay the provider for services, and the amount, if any, of copayment that is your responsibility. Your policy may place a limitation on the number of sessions that you can receive. If you use the allotted number of visits authorized by your plan, your clinician may seek authorization for additional sessions from your insurance company.
How do I find out this information?
There is a toll-free number on the back of your insurance card that you may call to obtain information about your mental health benefits.
Can I see anyone I choose?
If you would like to use your insurance plan, you must verify with both the clinician and the insurance company that the provider is in-network. Please visit the Clinicianslinicians page to learn if the clinician you are interested in working with is an in-network provider for your insurance plan.
Some plans allow you to select a provider who is not contracted with your insurance company as an out-of-network option. Choosing a provider who is out of network typically means you will pay a larger percentage of the cost for the service. You may be required to pay the clinician’s full fee upfront and be reimbursed by your insurance company.
Do I need pre-authorization for office visits?
Certain plans require preauthorization from the specific insurance company or a referral from your PCP or other treater. To find out the pre-authorization requirements under your specific plan, call the toll-free number on the back of your insurance card.
Are there advantages to paying out-of pocket?
For some people, concerns about confidentiality is the key reason that they chose to not submit claims to their insurance company. Therapists must provide minimal information about diagnosis and treatment in order to receive payment for services, and this information becomes a part of your medical record. In addition, insurance companies may limit number or types of sessions that they cover.
What services are not covered?
Services such as coaching, court testimony, school visits, telephone and email communications, consultations, and collaboration with other professionals are not covered by insurance. Certain specialized services (e.g., hypnotherapy, biofeedback) also may not be covered. Some clinicians may charge an out of pocket fee for cancellations that occur less than 24 hours before your appointment. This fee is not billable to insurance. Please check with the individual provider about his/her fees and policies on no-shows/cancellations.
What is the most important issue for me to keep in mind about insurance coverage?
As the patient, you are ultimately financially responsible for the services you receive. It is important to have a good understanding of your mental health benefits before you initiate treatment.