Hi there — we put this FAQ together to make the transition as smooth as possible. If you don’t see your question answered, reach out anytime. We’re here to help.
What does “out-of-network” mean?
- We don’t bill your insurance directly.
- You pay TheraCouch at the time of service.
- If your plan offers OON mental health benefits, you can submit a claim to your insurer for reimbursement.
- Reimbursement amounts vary by plan and are not guaranteed.
Fees
- 60-minute individual psychotherapy (CPT 90837): $250
- Intake/initial evaluation (CPT 90791): $300
- Payment is due at each session. HSA/FSA cards are typically accepted.
Note: We’ll provide a superbill with all required details (CPT code, diagnosis if applicable, date, fee, provider info).
How do I use my OON benefits?
- Pay for your session at the time of service.
- Receive your superbill from TheraCouch (usually monthly or by request).
- Submit the superbill to your insurer (via member portal, app, or mail).
- Your insurer processes the claim and, if eligible, reimburses you directly.
Typical processing time: 2–6 weeks (varies by insurer).
What should I ask my insurance company?
Call the number on your insurance card (Member Services) and ask:
- Do I have out-of-network benefits for outpatient mental health/behavioral health?
- Are telehealth visits covered out-of-network?
- What are my OON deductible and how much has been met this year?
- After I meet the deductible, what percentage do you reimburse (coinsurance) for: CPT 90791 (intake) – CPT 90837 (60-minute psychotherapy)
Tip: Ask for a reference number for the call and document who you spoke with.
Open Enrollment tips (choosing a plan with OON coverage)
- Prefer PPO or POS plans; HMOs/EPOs often have no OON coverage.
- Confirm OON mental health benefits (outpatient psychotherapy).
- Check deductibles and coinsurance for OON services.
- Verify telehealth is covered out-of-network and for mental health.
- Ensure FSA/HSA options if helpful to you.
Telehealth
- Confirm your OON telehealth coverage, platform requirements, and any modifiers your insurer expects. – We will include the correct place-of-service and telehealth details on superbills as applicable.
Payment methods
- All major credit cards and debit cards, HSA/FSA cards.
- Payment is due at the time of service.
- You receive receipts and/or monthly superbills for your records.
Good Faith Estimate (No Surprises Act)
You have the right to receive a Good Faith Estimate of expected charges upon scheduling or request. This estimate is not a contract, and actual costs may vary based on your needs. We’re happy to provide one at any time.