How to Use Out-of-Network Benefits for Therapy

Written By Taylor Bowman

If you’ve found a therapist you really click with but they don’t take your insurance, don’t panic. You may still be able to get some of your money back for sessions using your out-of-network benefits. Here’s the exact breakdown for finding out if your insurance plan allows for this without getting lost in complicated insurance lingo.

1. Call Your Insurance company
(usually best to do early in the morning before long wait times)

Once you’re connected, here is what to ask about:

  • Do I have out-of-network benefits for outpatient mental health?

  • Have I met my out-of-network deductible yet? If not, how much is it?

  • What’s the reimbursement rate for CPT code 90834? (this is the code for individual therapy sessions).

  • Do I need to get pre-approved?

  • How do I submit a superbill?

Pro tip: Keep a note open on your phone and write down what they say—it’s easy to forget later.

2. Pay for Your Session and Get a Superbill

Since the therapist is likely an out-of-network provider, you’ll pay them directly following each session. Once sessions are paid, you’ll receive a superbill which is formal word for the detailed receipt with the necessary info your insurance company needs to process the claim.

3. Submit the Superbill

You can usually upload it on your insurance company’s website or app. Some insurance companies also accept claims by mail or fax (yes, really). If that sounds like a headache, there are apps like Reimbursify or Mentaya that can do it for you.

4. Get Reimbursed

Once it’s processed, your insurance will mail you a check or deposit money into your account—reimbursement goes directly to you. How much you get back depends on your plan. For example:

If a provider charges $150 and your insurance “allows” $110 and reimburses 60%, you’d get $66 back. Your real out-of-pocket cost becomes $84 instead of $150.

You Deserve Support That Fits You

Starting therapy is a certainly an investment and navigating insurance doesn’t have to be a dealbreaker. Out-of-network benefits can absolutely allow you more freedom to choose the therapist that feels like the right fit, without compromising care.

If you're unsure of how to start, I’m happy to guide you through it or provide everything you need to submit claims. You don’t have to figure it all out alone.

Your growth, healing, and peace of mind are worth investing in. And you likely have more support than you think!

Taylor Bowman
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