Being out-of-network providers

No, our therapists are not in-network with any insurance companies and we do not bill insurances on your behalf for session payment.

That being said, many insurance plans do offer benefits that cover “out of network” providers (we’ve seen anywhere from 25-75% of session fees) and we encourage you to find out if that’s true for you.

There are three reasons we choose to be “out-of-network providers”:

1) We are freed to focus 100% of our time and energy on working with you.

When therapists are in-network with insurance companies, it often means they have to spend hours of their time completing insurance paperwork for you and your sessions or tracking invoices and administrative headaches. By choosing to be out of network, your therapist can spend that time preparing for your sessions, attending workshops on cutting edge treatment approaches, seeking consultation or specialty professional development, or simply practicing their own self-care so they are at their best. Being out of network also means that your therapy will never be dictated or interrupted by managed care policies (e.g., an insurance company putting a limit to number of sessions per year or deeming a select type of therapy as “acceptable” for reimbursement). Since insurance representatives are not mental health professionals and possess no clinical training, we don’t believe they should be in a position to make those decisions for you.

2) We can compensate our psychologists on time and more competitively - this directly supports their professional health (and ability to do their best work with you).

More often than not, insurances compensate therapists for sessions they’ve held with their patients on a very delayed timetable. Sometimes therapists won’t receive payment for weeks or months after sessions (if at all), and when they do, payment is usually lower than their market value or standard rate. This means therapists have to work more hours to earn the same amount they would receive if they were out of network providers, or in the worst case scenarios, therapists have to spend more time following up on pay they are owed. This is a quick path to professional burnout. The mental health of our psychologists at Manhattan Therapy Collective is a priority and paramount to their ability to show up for you and do their best work.

3) One of our practice’s priorities is charitable giving.

We donate a percentage of our session fees to a local non-profit every year that provides mental health or human services in New York City. Opting to be out of network providers allows us to be generous and stay committed to our goal as a group practice to have a tangible, positive social impact in the city.

Possibly! It depends on the benefits of your specific insurance plan. Some insurance plans include “out of network mental health benefits” - which means even if you see a therapist who is not on their list of approved “in-network” providers, you may be eligible for some reimbursement of session fees.

We provide invoices, or “superbills” for you after each session. These superbills include all of the information needed to file an insurance claim and many of our patients submit these directly for reimbursement.

We highly encourage you to follow up with your insurance plan if you are unsure about what is covered and ask! Usually there is a phone number on the back of your insurance card that you can call to speak with an insurance representative, or a website where you can access your plan information.

Here are some questions to ask:

• Do I have “out of network mental health benefits”?

• If so, how much per session or what percentage of my session fee can be reimbursed?

• Do I have a deductible I need to meet first before being eligible for reimbursement? If so, what is it?

• Do I have a co-pay?

• How do I submit claims in order to receive reimbursement?

• What information is necessary in order to submit my claims?

• How long on average does it take to receive my reimbursement check?

• Do I have a session limit or is there any pre-authorization from my therapist required?

Those who have “out of network mental health benefits” are usually asked to submit invoices from attended therapy sessions that include a CPT/service code and a diagnostic code. Our invoices (called “superbills” ) will always include this information. Please contact us with any further questions.

No, unfortunately we do not assist in submitting any insurance-related invoices. We can answer any questions you may have about the invoices (also called superbills) you would submit at any time.

The CPT code is a 5-digit number used to categorize what service is being provided and billed for. Here are the most common CPT codes used:

90791 = your first 60-minute intake session

90834 = 45-minute individual therapy

For sessions that are conducted via teletherapy, the modifier “-95” is attached to the CPT code. For example, an individual teletherapy session would be 90834-95. Please ask your therapist if you have additional questions.

Yes!

One of the biggest reasons we think you should work with an OON therapist is if you are looking for a highly specialized or niche therapist - like a cognitive behavioral therapist, insomnia therapist, trauma therapist, or person of color or BIPOC therapist with multicultural training in mental health. Most therapists can address common mental health concerns like anxiety and depression with a mix of approaches. However if you are interested in a therapist who uses a specific type of therapy, like evidence-based therapies (i.e., ones that has been researched and backed by science) or a multiculturally trained therapist - try going out of network, as they are far less common. Keep in mind that it can be financially worthwhile to work with an out of network therapist with specialty training in your concerns so you get what you’re looking for - instead of wondering if you will (and end up spending more in the meanwhile).

Payment for therapy is due upon service. In other words, payment is expected when you attend a session - we do not bill monthly or create payment plans. We accept most major credit cards and checks made out to “Manhattan Therapy Collective Psychological Services, PLLC”. Please ask your therapist before your session if you have questions about a specific form of payment. Upon payment, your therapist will email you a copy of your completed invoice.

We know that therapy is a financial investment. Know that our session fees are not random. We make it a point to set our fees in accordance to average market value rates for the zip code we serve, the doctoral-level of training our psychologists possess, and their respective specialties. Our fee range also reflects the fact that we are committed to maintaining office space in NYC and offering the option of in-person sessions to all of our patients.

Starting January 1, 2022, out of network providers are federally mandated to provide patients a “good faith estimate” that outlines the expected cost of treatment. This is incorporated into the initial paperwork that we require all new patients to complete prior to beginning therapy. For more information about your rights, read about the No Surprises Act .