Rates & Insurance

WE ARE AN OUT-OF-NETWORK PROVIDER, AND YOU MAY BE ABLE TO USE YOUR INSURANCE BENEFITS TO HELP COVER THE COSTS OF YOUR SESSION.

To use your insurance for part of your therapy sessions, please reach out to your insurance provider before your first appointment. You can find the phone number on the back of your insurance card, typically listed under "behavioral health" or "mental health." If these categories are not mentioned, call the number for member customer service and request to speak with someone regarding your Outpatient Behavioral Health Benefits.

Remember, these are your benefits. Don’t hesitate to insist on getting the information you need and make sure they don’t give you the runaround.

Here are some questions you can ask to learn about your Outpatient Behavioral Health Benefits:

1. Do I have out-of-network mental health coverage?

   When asking this question, the representative might request the “CPT code” or “service code.” Below are the codes for the services we provide:

   • Initial Evaluation (your first appointment) - 90791
   • Individual Therapy Session (only you attending therapy) - 90834
   • Couples or Family Therapy Session (attending therapy with your significant other or a family member) - 90847
   • Group Sessions - 90853

   If NO: Your coverage will not reimburse you for any part of our visits. You have the option to continue therapy sessions and pay in full without expecting reimbursement, or you can ask the representative to assist you in finding a therapist within your plan.

   If YES: Excellent. Here are additional questions you should ask:

2. Can I be reimbursed for my therapist’s license or registration type?

   Certain insurance plans may not reimburse for services provided by specific professionals. Colt Gordon is a Licensed Clinical Social Worker (LCSW).

3. Do I have a deductible?

   A deductible is the amount you must pay out of pocket before your insurance starts covering costs. If you do have a deductible, be sure to ask: What is the total amount, and how much remains?

4. What is my co-insurance?

   Co-insurance is the percentage of the fee you are responsible for paying. For instance, your insurance may cover 80% of the fee, leaving you to pay the remaining 20%. If your insurance company states they will reimburse a certain percentage of the Usual and Customary Rate, be aware that this rate may differ from our fees. Therefore, ask for the specific amount to anticipate your reimbursement.

   When inquiring about the Usual and Customary Rate, your insurance company might request the zip code of the therapy practice. The zip code for our California practice is 90029.  The zip code for our Wyoming practice is 82414.

5. Is there a limit to how many mental health visits I may receive per calendar year?

   If there is a limit, ask how many visits are covered per year.

6. Do I need authorization for my visits?

   If authorization is required, ask for an authorization number and the number of sessions authorized.

7. Can you tell me the procedure and address to submit a superbill and receive out-of-network reimbursement?

   If you encounter any issues or have questions about this process, I am happy to assist you. Please note that I cannot guarantee out-of-network insurance reimbursement.