About: Insurance & Costs

Out-of-Network

J&L Psychology Group is an out-of-network provider for your health insurance plan. However, many plans offer coverage for out-of-network behavioral health. This guide will help you determine the benefits your plan may offer. 

​Please note, you will be charged at the time of service and provided a receipt to submit to your insurance plan for reimbursement. Knowing what to expect for out-of-network coverage can help you make an informed decision before starting treatment.

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Out-Of-Network Value

By not working directly with an insurance company, we have the freedom to provide personalized care. Your treatment, tailored to exactly your needs, without a third party directing how treatment should proceed.  

Finding care out-of-network allows you to choose your quality of treatment, your doctor, and maintains your privacy.

Current Rates

Our rates are competitive with out-of-network group private practices in the New York City metro area and vary according to individual clinicians, all of whom are experienced psychologists with various areas of expertise. During your initial free phone consultation, our administrative assistant will provide you with information about our therapists, their fees, availability, and  scheduling. We will work with you to coordinate the best fit for your needs.

Jennifer Newman, phd (Practice co-founder)

$400 for initial intake and 45-minute individual therapy sessions
$500 for couples, families, and 60-minute individual therapy sessions

*For intensive session(s) (e.g., EMDR, exposure therapy, extended sessions):
Added time to original session is $200 for 30 minutes; $400 for 60 minutes (see codes below).
​
License: NY; certification: FLA (telehealth only)

laura price, phd (practice co-founder)

$400 for initial intake and 45-minute individual therapy sessions
$500 for couples, families, and 60-minute individual therapy sessions

​*For intensive session(s) (e.g., exposure therapy, extended sessions):
Added time to original session is $200 for 30 minutes; $400 for 60 minutes (see codes below).
Licenses: NY, CT; certification: FLA (telehealth only); APIT-certified in PSYPACT states

Rachel goldman, phd (staff clinician)

$375 for initial intake and 45-minute individual therapy sessions
$425 for couples, families, 60-minute individual therapy sessions

*For intensive session(s) (e.g., exposure therapy, extended sessions):
Added time to original session is  $187.50 for 30 minutes or $375 for 60 minutes (see codes below).

​Licenses: NY, CA; certification: FLA (telehealth only)

Questions to ask your insurance carrier

If you have insurance, it is recommended that you call your insurance plan before starting sessions and inquire about "behavioral health care" out-of-network reimbursement. You can contact them by using the number on the back of your insurance card or going to the online portal for your carrier.

When contacting your plan, these are the questions you should ask:

1.  What are the out-of-network behavioral health care reimbursement rates for the following types of sessions?

• Initial evaluation session (CPT code = 90791) 
• 45-minute therapy session (CPT code = 90834)
• 60-minute therapy session (CPT code = 90837) 
• **Family therapy session (CPT code = 90847) 
• **Family therapy w/o patient present (CPT code 90846)

​2. Do I need pre-approval for a longer session (60-minute session)?

• *Add-on code 90838 (60 minutes) or 90833 (30 minutes)

​3. Am I allowed to have virtual sessions for therapy covered?

4. Is there a limited number of sessions I can receive in a calendar year?

5. Is there a cap on the allowable billable amount per session? 

6. How long after do I have after a session before I need to submit my receipt(s)?

7. What is the best way to submit my receipt(s)?
 
8. Is there a deductible that must be reached before I am eligible to receive reimbursements?

Please note, if you are on a family insurance plan, you should ask about the deductible for the family, and how that pertains to you as an individual.
​It is your responsibility to be informed about the specifics of your insurance plan before beginning sessions. The above questions serve as a guide for the typical questions you should ask. Also, plans will change their benefits periodically, so you should stay informed about any changes to your coverage.

Submitting receipts to insurance

1. Sign on to your Simple Practice account.
2. Go to the billing & payments section of the Simple Practice portal.
3. In the “insurance reimbursement statements” section are the documents you will need to submit to your insurance carrier:

• On the 1st of each month a “superbill” listing completed sessions from the previous month is available in your portal. It has the information your insurance company will need for reimbursement.
• Download and/or print the document.
• Submit the document to your plan through their on-line portal/fax/ mail.
• Note: Submitting these as close to the 1st of the month as possible will help make sure the claims are received on time.

**IMPORTANT NOTICE FOR FAMILIES AND COUPLES:
​Insurance companies require specific documentation and billing for couples and families. Please speak with your provider about the differences between insurance reimbursement requirements and private pay options to help you make an informed choice about how to proceed before you begin treatment.

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