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Therapy Fees and Rates in California
Therapy at Smart Talk Therapy costs between $120 and $200 per session, depending on whether you are coming individually or as a couple and on the experience level of the therapist you work with. We are a private pay practice, which means we do not bill insurance directly. Instead, we can provide you with a superbill you submit to your insurance company for possible out-of-network reimbursement. That choice is deliberate, and below we explain both what you get from it and what it costs you, so you can decide whether it makes sense for your situation.
Private Pay Therapy
Privately paying for therapy offers many benefits. The biggest benefit is full privacy since we will not need to share a diagnosis with your insurance company, family members on your plan will not know that you are in treatment, and you will not have a "pre-existing condition". This ensures you can speak openly and honestly about what brings you in. Additionally, research shows that a personal financial incentive usually helps clients start feeling better faster. When you pay for each session out of pocket, you tend to put more work into making each session count.
Insurance Paid Therapy
There are also benefits to using your insurance. The biggest benefit to using your insurance is cost. You will only need to pay your co-pay or co-insurance for each session so if you're on a budget then insurance might be the way to go. However, insurance companies do require that we provide a diagnosis as well as dates of service so your treatment will not be as private. Additionally, insurance companies have a right to audit your client chart that could include notes regarding your treatment. We are currently in-network with a limited number of insurance companies. To find out whether you can use your insurance for therapy please schedule a free consultation.
What a Superbill is and How to Use it
A superbill is an itemized receipt. After your session, we give you a document that lists the date, the service provided, a diagnosis code, our credentials and practice information, and what you paid. You submit that to your insurance company yourself, and they decide whether to reimburse you.
How the money actually works. Most PPO plans include out-of-network benefits, though the specifics vary widely. Typically there is an out-of-network deductible you have to meet first, and after that the plan reimburses a percentage of what you paid. That percentage often lands somewhere between 50 and 80 percent, but it depends entirely on your plan. Some plans reimburse against their own allowed amount rather than your actual fee, which means the percentage you receive back may be calculated on a lower number than what you paid.
What to ask your insurance company before you start. Call the member services number on the back of your card and ask four questions. Do I have out-of-network outpatient mental health benefits? What is my out-of-network deductible and how much of it have I met? What percentage do you reimburse after the deductible? Do you reimburse based on my provider's actual fee or on an allowed amount?
Those four answers tell you almost exactly what therapy will cost you. It is a ten minute phone call and it is worth making before your first session rather than after.
One thing worth knowing. A superbill requires a mental health diagnosis, because insurance companies will not reimburse without one. If full privacy is your priority, paying without submitting a superbill keeps your treatment entirely between you and your therapist.
Reimbursement is never guaranteed. We can provide the documentation, and we are glad to. What your plan does with it is between you and them.