Couple’s Counseling with Confidence: Part 9 – How to Use Insurance for Couple’s Counseling

Many insurance plans will reimburse for couple’s counseling. Understanding your coverage options and how to utilize them can help minimize surprises and manage costs effectively. Here are the crucial questions to consider for a smooth experience with both your therapist and your insurance provider.

Is Your Couple’s Counselor In-Network?

Begin by asking your therapist if they are an in-network provider with your insurance carrier. Many insurance providers cover couple’s counseling, particularly if the therapist is in-network. Being in-network means that the therapist has a contract with the insurance company to offer services to its members.

If your therapist is in-network, all you typically need to do is provide your insurance information to your therapist, who will then handle the necessary paperwork. It’s also a good idea to contact your insurance provider to understand aspects such as coinsurance, copays, and deductibles. Keep in mind that some therapists might delay submitting claims for several sessions, so you may be expected to pay copays or coinsurances “in bulk.”

Out-of-Network Considerations

If your therapist isn’t in-network, things might get a bit more complicated. First, call your insurance company to see if they reimburse for out-of-network couples therapy. You’ll need to provide details about your therapist, such as their professional credentials, which often start with “licensed”—for example, a “licensed” marriage and family therapist or a “licensed” clinical social worker.

Providing the correct billing code, known as the CPT code, to your insurance company is essential. The code for family or couples therapy is 90847. It’s beneficial to have this number on hand as you navigate your insurance options.

Submitting Out-of-Network Claims

If your insurance company does reimburse for out-of-network services, be prepared to pay your therapist out-of-pocket up front. You’ll then submit an out-of-network claim on your own. To do this, first, check with your insurance company on how to process such claims.

You’ll also need a document called a “super bill” from your therapist. The super bill is critical for filing your out-of-network claim. It includes detailed information about the services provided, which your insurance company requires to process your claim.

Conclusion

Navigating insurance for couple’s counseling can seem daunting, but by asking the right questions and understanding the necessary steps, you can make the process much smoother. Ensure that you’re well-informed about your coverage to avoid unexpected financial burdens, allowing you to focus on your journey to improved relationships and well-being.