Why Choose an Out-of-Network Provider?
Most experienced therapists don’t accept insurance. Why?
Unlike physicians or dentists who are typically in-network, mental health practitioners often operate as out-of-network providers. This is because they are reimbursed at comparatively lower rates, making it challenging to financially sustain their practice.
For clients, this means that seasoned therapists will often be out-of-network, resulting in higher costs but more skilled care. Learn more below…
Navigating options for therapy is overwhelming…
A key decision is whether to use an out-of-network provider or opt for in-network services or online platforms like BetterHelp. Here’s why choosing an out-of-network provider may better suit your mental health needs.
Personalized, High-Quality Care
Out-of-network providers offer a more personalized approach to therapy. Free from insurance constraints, they can tailor treatment plans specifically to your needs, often leading to more meaningful progress.
Experienced & Specialized Therapists
These therapists often have extensive experience and specialized training in various therapeutic modalities, catering to clients seeking high-level expertise for specific issues or complex challenges.
Learn About a Therapist’s Experience Using BetterHelp.
Greater Privacy & Confidentiality
With out-of-network therapy, your privacy is better protected. Insurance companies require detailed information about your diagnosis and treatment, potentially compromising confidentiality.
Control Over Treatment
Without insurance restrictions, out-of-network therapists can offer more flexible and individualized treatment plans. You can decide the frequency and length of your sessions, allowing therapy to progress at a pace that suits you best.
Read a Propublicla Article explaining the problems with In-Network Care.
Drawbacks of Alternatives:
Therapist Fatigue: In-network therapists often have high caseloads, impacting availability and quality of care.
Standardized Treatment: In-network providers follow strict insurance guidelines, which may lead to a less personalized approach.
Time Constraints: Insurance companies may limit sessions, potentially hindering progress. Out-of-network providers offer therapy for as long as you need.
Online Therapy Limitations: Services like BetterHelp and Talkspace lack the depth and continuity of in-person therapy, often providing less personalized support.
Impersonal Experience: Online services may involve less consistent interaction with the same therapist, hindering strong therapeutic relationships.
Choosing an out-of-network provider is an investment in your mental health. While it may involve higher upfront costs, the benefits of personalized, confidential, and flexible services dramatically affects quality of care. Furthermore, many insurance plans offer substantial reimbursement for out-of-network psychotherapy—upwards of 80%.
Read below to learn what questions to ask about your out-of-network benefits.
Contact us to experience a higher level of service.
What questions should I ask my insurer?
Do I have out of network benefits for outpatient mental health services?
What is my out-of-network deductible and has it been met?
What is the percentage of reimbursement for an out-of-network provider for outpatient psychotherapy services, once my deductible has been met? Your insurance company may ask you what the “service code” is. Here are the service codes we use:
90791: Initial Intake session
90834: 45-50 minute psychotherapy session
90834-95: 45-50 minute tele-health psychotherapy session
**Note that the percentage of reimbursement may be based on the insurance company’s “allowable rate.” For example, the insurance company may deem a therapy session to be “worth” $100, regardless of the clinician’s actual fee. In this example, if they reimburse at 80% ; the member would be reimbursed $80.