Using out-of-network benefits for therapy
If we're not in your plan's network — or your plan only has out-of-network mental-health coverage — you can often still get money back for therapy. Here's how superbills and reimbursement actually work, in plain English.
- Most major insurance accepted
- Same-week openings
- Evening & virtual appointments
- Free parking at our Carrollton office
What “out-of-network” actually means
In-network means a therapist has a contract with your insurance plan and bills the plan directly — you pay a copay or coinsurance.
Out-of-network means there's no contract. You pay the practice directly, and then your plan may pay you back a share of each session — that's reimbursement, and the superbill is how you claim it.
Many PPO plans include out-of-network mental-health benefits. Most HMO and EPO plans don't — which is exactly why the first step below is one quick phone call.
Three numbers that decide your reimbursement
Out-of-network deductible: what you pay out of pocket each year before reimbursement starts. Often separate from your in-network deductible.
Allowed amount: the rate your plan considers “reasonable” for a session. Reimbursement is a percentage of this number, not necessarily of what you paid.
Coinsurance percentage: the share of the allowed amount your plan sends back once the deductible is met.
One call to Member Services pins down all three.
What's on a superbill
A superbill is a detailed, itemized receipt of your sessions — we provide it, and you submit it to your plan. It carries everything an insurance company needs to process an out-of-network claim:
- The date of each session
- The service (CPT) code for the type of session
- A diagnosis code
- Your therapist's name, license, and NPI number
- The practice's information
- What you paid
Most plans accept superbills through the member portal or mobile app (usually under “submit a claim”); some still take them by mail. Your plan's Member Services line will tell you which.
Worth knowing before you decide
A superbill includes a diagnosis code — that's what makes it reimbursable. If you'd rather not have a diagnosis on file with your insurance company, straight self-pay without a superbill may be the better fit. Both are completely fine with us — it's your call, and we'll explain the trade-off whenever you want to talk it through.
How to use your out-of-network benefits
Call your plan & ask five questions
Grab the Member Services number on the back of your insurance card and ask:
- Do I have out-of-network benefits for outpatient mental health (therapy) visits?
- What's my out-of-network deductible — and how much is left this year?
- What percentage of the allowed amount do you reimburse per session?
- How do I submit a superbill — portal, app, or mail?
- Is telehealth reimbursed the same as in-person?
Come to therapy — and ask us for a superbill
You pay our self-pay rate at the time of your sessions, and we provide a superbill with everything your plan needs. We'll walk you through exactly how payment and billing work before your first session — no surprises.
Submit it & track the claim
Upload the superbill through your member portal or app (or mail it, if your plan is old-school). Reimbursement usually arrives as a check or deposit once the claim processes — timing varies by insurer, so keep an eye on your claims page.
When out-of-network benefits earn their keep
You want a specific therapist
PPO out-of-network benefits exist precisely so you're not limited to a directory. If the right fit for you or your child is here, your plan may still share the cost.
You have a high-deductible plan
If you'd be paying out of pocket anyway, superbilled sessions can count toward your out-of-network deductible — ask your plan how it tracks them.
Your plan isn't one we accept
We accept most major insurance — but if yours isn't on the list, out-of-network benefits are how you keep using it here. Call and we'll check together.
An honest note about couples counseling
Insurance plans reimburse therapy tied to a diagnosed condition — and that applies out-of-network too. Couples counseling on its own often doesn't qualify, though every plan is different.
If yours doesn't cover it, our self-pay rates keep it within reach — and our couples intensives are a popular self-pay option. Call and we'll help you sort it out.
Prefer not to use insurance — or don't have it?
Our self-pay sessions are available at a range of rates — call (972) 885-1222 and we'll find one that fits. We're committed to making sure cost isn't the reason you don't get support.
Your right to a “Good Faith Estimate”
Under the law, health care providers need to give patients who don't have insurance, or who are not using insurance, an estimate of the bill for medical items and services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services, including related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.
Questions we hear a lot
Do you provide superbills?
Yes — ask us and we'll provide a detailed superbill for your sessions, with the codes and provider details your plan needs. We'll also walk you through exactly how payment and billing work before your first session.
How much will I get back?
That depends on your plan's out-of-network deductible, its allowed amount, and its coinsurance percentage — so we can't promise a number. The five questions above get your plan's real figures in one phone call, and we're happy to help you make sense of what they tell you.
How long does reimbursement take?
It varies by insurer. Many plans process out-of-network claims within a few weeks of submission; your member portal's claims page is the best place to watch progress. If a claim stalls, a quick call to Member Services usually shakes it loose.
Do superbills work for couples counseling?
Often not on their own — insurers reimburse treatment for a diagnosed condition, and standalone couples counseling frequently doesn't qualify, even out-of-network. Many couples simply use our self-pay rates; call and we'll walk through your options.
Can I use an HSA or FSA to pay for therapy?
Generally yes — therapy for a health concern is typically an eligible expense, whether or not you also submit a superbill. Pay with your HSA/FSA card or keep your receipts, and confirm the details with your plan administrator.
What's a CPT code?
It's the standard code that tells an insurer what kind of service a session was. You don't have to figure it out — it's on the superbill automatically, which is what makes the claim processable.
Have a different plan?
“Most major insurance accepted” means exactly that — start with our rates & insurance overview or jump to your plan:
Let's figure out coverage together
We'll answer your insurance questions, help you understand your options, and match you with the right therapist.
Let'sTalk! Counseling · 4125 Fairway Dr #130, Carrollton, TX 75010 · Mon–Thu 8am–7pm · Fri 9am–5pm · Sat 9am–12pm
Serving Carrollton, Coppell, Lewisville, Flower Mound, The Colony, Frisco, Plano & the DFW metro — in person or online across Texas.