Scheduling & Fees New

Your relationship is a worthwhile investment; it has incredible potential to grow and enhance your life. With that said, many couples, understandably, struggle with whether or not therapy is worth the cost. We have written an article to help you weigh the costs and benefits of couples therapy. In addition, here are some points to consider related to this question:

• The immediate cost of divorce (e.g., attorney fees) averages $12,000-$15,000, not to mention the ongoing expenses of maintaining separate households.
• Couples in troubled marriages are significantly more likely to have compromised immune systems, elevated stress hormone levels, and other markers of early mortality (Robles & Kiecolt-Glaser, 2003). Yes! A bad relationship can actually shorten your life.
• Creating ashealthy a marriage as possible can have intergenerational effects, as children witness and experience the effects of a healthy relationship.
•  The average wedding costs about $23,000. An investment in preventing divorce and setting as good a trajectory for a marriage as possible is also a worthy investment.
• The vast majority of couples (around 75%) experience significant improvement in their relationship when the therapist is using an evidenced-based model (Gottman, 2015).

In short, the vast majority of people receive a significant return on their couples therapy investment. 

No, we do not accept insurance.

Important Information About Insurance Reimbursement

At Connect Couples Therapy, we are a private pay practice and do not have direct agreements with insurance companies. However, if requested by you, we are happy to provide you with a superbill—a detailed receipt that you can submit to your insurance company for potential reimbursement. You can read more about the superbill process on our blog.

Please note the following important considerations:

• • Insurance Plan Limitations: Not all insurance plans cover every diagnosis or type of therapy service. Some plans may deny claims if the diagnosis code on the superbill does not meet their medical necessity criteria.
  • Out-of-Network Benefits: Reimbursement depends on your specific out-of-network benefits, which vary by plan. Some plans do not offer out-of-network coverage at all.
  • Checking Your Benefits: Before starting therapy, we recommend that you:
    • Contact your insurance company to confirm your out-of-network benefits.
    • Inquire about reimbursement rates for therapy services with specific codes (e.g., CPT and diagnosis codes).
    • Ask about deductibles, required documentation, and other limitations.

Service Information as part of the couples therapy assessment and treatment sessions are detailed as follows:

• Code 90791: Therapy Intake
• Code 90837: Psychotherapy Session 50-min
• Code 90847: Psychotherapy session with patient and family member 80-min
• Diagnostic Codes: V61.10 – Counseling for unspecified marital and partner problems or Z63.0 – Relationship distress with spouse or intimate partner

Once we send you a superbill with the appropriate diagnostic code, we will not revise it or change the code to match what the insurance says it will cover and reimburse. Altering a diagnosis solely to secure reimbursement can lead to legal consequences and violates professional codes of conduct. Instead, we encourage our clients to advocate with their insurance companies for clearer coverage guidelines.

We strive to provide transparent information to help you navigate the insurance process. 

YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS

(OMB Control Number: 0938-1401)

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs,     such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care – like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you unless you give written consent and give up your protections.

You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.

• Your health plan generally must:

• • Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).

• • Cover emergency services by out-of-network providers.

• • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.

• • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you think you’ve been wrongly billed, contact the federal phone number for information and complaints at 1-800-985-3059.

Visit www.cms.gov/nosurprises/consumers for more information about your rights under Federal law.