Out-Of-Network Family Therapy
At Your Gray Matters, the fee is $175 for individuals and $200 for couples for a typical 50 minute therapy session.
Do you accept insurance?
- The short answer is no we do not bill insurance companies directly for payment.
- Gray Matters is an out of network provider for all PPO plans, so insurance is not required.
- PPOs typically reimburse 50%
- I will provide you with an invoice, commonly called a super-bill, which you can submit to your insurance company to seek reimbursement of fees already paid.
- The full session fee is due at the time of service
If you have a PPO insurance plan, here are some tips:
If you have insurance, check with your provider. Ask the following about your coverage for out of network providers regarding mental health benefits to see if you may be eligible for reimbursement:
- Does my plan provide mental health benefits?
- What diagnoses are included or excluded by the plan?
- Does the plan provide reimbursement for out of network providers? If so, how much?
- Does my insurance cover individual, family, child or couples counseling?
- What Procedure codes are covered?
What are the benefits of not using insurance?
- No need to verify the “medical necessity” for your therapy
- You do not need to be in a crisis or have a severe mental illness to receive therapy
- You do not have to meet the criteria of your insurance company mental health diagnosis
- Allows you and the therapist to determine your treatment plan, number of visits, type of therapy (such as family or couples)
- More flexibility in choosing the issues to focus on during therapy
- Increased confidentiality – your assessments, diagnoses, and treatment plans are not shared with the insurance company
- Maintain privacy and avoid compulsory diagnoses
- You are not bound by insurance criteria and pre-authorizations which can stop the therapeutic process
- No interruption to therapy if insurance plans are stopped and started due employee benefit changes
- No mandatory assessments, evaluations or periodic chart audits (often required by insurance companies)
- You, not your insurance provider, will dictate how and when you will be receiving services.
Does insurance cover couples, family, or pre-marital counseling?
Insurance companies do not reimburse for couples, pre-marital or family therapy.
However, it is important to note that couples will benefit from being seen individually, especially when one partner is not willing or ready to come in together for therapy. In addition, some couples who have a history of current or domestic violence do not benefit from being seen together. Furthermore, couples may have different goals and interests for the relationship and it is an opportunity to work on differentiating goals before beginning couples therapy.