Insurance & Fees

In-Network Insurance

We accept Highmark Blue Shield (PPO), and Blue Cross Blue Shield plans (PPO), however not all insurance plans cover mental health services with our providers.

We do not accept Independence BC plans including Personal Choice and Keystone HMO.

Please contact your insurance provider to better understand your coverage with our group. They may ask for information about us: Our Group NPI number is 1063181964 and the CPT codes are 90791 and 90837. We do not participate in EAP programs.

Questions to ask your insurance provider:

• What is my coverage for Outpatient Mental Health with a Provider (not facility)?
• Is Telehealth covered? 
• Do I have a copayment or coinsurance?
• What is my deductible? How much of my deductible has been met?  

Out-of-Network Coverage and Possible Benefits

Find out if you qualify for out-of-network reimbursement. You may then request an invoice or “superbill” to submit to them. However, we are not able to guarantee that the claim will be approved. 

Questions to ask your insurance provider:

• Are there out-of-network benefits for this policy?
• Do I have a mental or behavioral health policy with out-of-network benefits?
• What are the requirements to use out-of-network benefits?
• Is prior authorization required? Is a referral required from my primary care physician?
• Do I have an out-of-network deductible? If yes:
• What is my out-of-network deductible?
• How much of my out-of-network deductible has been met?
• What is the start date of the calendar year my out-of-network policy is based on?
• Ask the representative if your policy covers couples therapy, CPT code 90847. How much is the insurance company’s “usual and customary fee” and what percentage do they cover?

You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost

Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items and services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill,

Make sure to save a copy or picture of your Good Faith Estimate.

For questions and more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059