• Does my insurance plan include mental health benefits? (CPT codes 90834 & 90837)
• What is my yearly deductible? Have I met my deductible?
• How many sessions per calendar year does my plan cover?
• What is the coverage amount per therapy session?
• How much does my plan cover for an out-of-network provider?
• What is my co-pay amount?
• Do I need a referral from my primary care physician?
• Is precertification or preauthorization required?

• What is my out-of-network deductible & co-insurance for a mental health office visit? (specifically CPT code 90834 & 90837)
• Do I need a referral from my primary care physician?
• Is precertification or preauthorization required?
• How do I submit claims for reimbursement?

• Does my policy cover telehealth? (CPT codes 90834 & 90837)
  • If yes… Does that apply to any in-network provider or only with a specific vendor? (i.e. MDLive, Doctor On Demand, etc.)
• Is the cost-share waived or am I still required to meet my deductible?
• Is there a specific billing code that needs to be used? (i.e. modifier 95)

A quote or estimate of benefits and/or authorization does not guarantee payment or verify eligibility. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time of service.

When utilizing your health insurance benefits, it is important that you understand your health insurance benefits before beginning any counseling or treatment.

Since each insurance plan is different, and coverage can vary significantly, verifying benefits ahead of time helps avoid unexpected expenses and ensures that you are fully aware of what your insurance plan covers and what it does not.