the practical part

Superbills, explained

By Valentina Alaimo, LCSW · More notes

Paying for therapy can feel confusing, especially when your therapist doesn't bill insurance directly. The good news is that many people can still get part of their costs back. Here's how it works, in plain language.

What is a superbill?

A superbill is a detailed receipt for your therapy sessions. It includes the information your insurance company needs, such as the dates of service, the type of session (called a CPT code), a diagnosis code, my license number and what you paid.

When a therapist is out-of-network, you pay the therapist directly. Then you send the superbill to your insurance company, and if your plan has out-of-network mental health benefits, they reimburse you for part of the cost.

What to ask your insurance

Call the member services number on the back of your card and ask:

1. "Do I have out-of-network mental health benefits for CPT codes 90791 (the first session) and 90837 (ongoing sessions)?"
2. "What is my out-of-network deductible, and how much of it have I met this year?"
3. "Once my deductible is met, what percentage do you reimburse?"
4. "How do I submit a superbill? Online, by mail or through your app?"

Their answers will tell you roughly how much you'll get back. PPO plans are the most likely to include out-of-network benefits. HMO and EPO plans often don't.

How the process usually goes

Good to know: You can also use an HSA or FSA card to pay for therapy. And if you're paying out of pocket, you're entitled to a Good Faith Estimate of your costs before we begin, under the federal No Surprises Act.

A few honest notes

• Every plan is different, so I can't promise how much your insurance will reimburse.
• Insurance companies require a diagnosis to reimburse. We can talk openly about what that means for you.
• If cost is a worry, please reach out anyway. I offer sliding scale fees, and if I'm not the right fit for your budget, I'll help you find someone who is.