Insurance Coverage for Therapy in NYC

The simplest in-network situation. Your behavioral health benefit pays in-network sessions, you owe a flat copay per session, and the deductible was either small or already met earlier in the year. We bill directly. You pay only the copay at the time of session.

High-deductible plans treat behavioral health like any other in-network service. Until you have hit the deductible, you pay the contracted in-network rate, which is meaningfully lower than self-pay. After deductible, you owe coinsurance or copay. Some clients on high-deductible plans reach the deductible partway through the year, depending on the plan.

Blue Cross, Oxford, United, Anthem, NYSHIP, and other PPO plans typically include an out-of-network behavioral health benefit. You pay our private rate at session. We provide a superbill upon request. You submit it to your plan and the insurer reimburses you based on your plan’s out-of-network rate.

COBRA Cigna or Aetna plans are in-network with us. Marketplace (ACA) Cigna or Aetna plans are also generally in-network. On the match call we share the questions to ask your insurance about the new plan during a job transition or open-enrollment change, so the work is not interrupted.

Some clients prefer to keep insurance out of clinical documentation. Private pay means you pay our private rate per session and we do not file with any insurance carrier. We do not issue a superbill if you do not want one issued. Suited for clients prioritizing clinical privacy.

We do not bill Medicaid or Medicare directly at this practice. If you have Medicaid or Medicare as your only coverage, we refer to a practice that does. If you have a secondary commercial plan, we can sometimes work the secondary path; on the match call we share the questions to ask the secondary carrier.

We are in-network with Cigna and Aetna, including Evernorth behavioral health (Cigna’s behavioral carrier) and Aetna Behavioral Health. For other carriers, we provide superbills you can submit to your insurance for out-of-network reimbursement.

Cost depends on your individual insurance plan. In-network sessions with Cigna or Aetna are billed through your behavioral health benefit. You typically owe your plan copay or coinsurance once any deductible has been met. We do not publish a flat dollar figure because the actual cost varies by plan and deductible status.

A superbill is a detailed receipt with the diagnostic and procedure codes your insurance needs for reimbursement. You pay our private rate at session, then submit the superbill to your insurance carrier. If your plan has out-of-network behavioral health benefits, your insurance reimburses you directly based on its out-of-network rate schedule.

Most in-network outpatient weekly therapy under Cigna or Aetna does not require prior authorization. Some employer-administered plans do require it. The way to confirm for your specific plan is to call the behavioral health number on the back of your insurance card, or wait until the matching call where we walk through it.

Yes. Cigna, Aetna, and most PPO plans cover HIPAA-secure telehealth sessions for behavioral health. We offer online video therapy across New York State, billed the same way as in-person sessions at our Midtown Manhattan office.

We are not in-network with Blue Cross Blue Shield, Oxford, United, NYSHIP, or Anthem. For these carriers we provide superbills upon request for out-of-network reimbursement. We also do not bill Medicaid or Medicare directly.

Most of our adult clients are in a first session within seven days of the matching call. Midtown office has current openings. Online video therapy is available statewide across New York.

Yes. Occasional alcohol or cannabis use is not a barrier. What we do not work with is active addiction. If alcohol, drugs, or another substance is in a pattern of addiction, we refer to specialized substance treatment first and hold a spot to start with us once that work is in place.