Insurance, Fees, and Payment

We know how important finances are in making the decision to seek our services. CEBT is a private pay practice, which means we ask for payment in full at the time of service and do not accept direct payment from insurance companies. However, we do help clients seeking out-of-network reimbursement from their insurance provider. Since we do not have access to anyone’s insurance policy benefits, the best way to find out information about out-of-network benefits is to call your insurance company.

Here are some specific questions to ask:

  • Does my policy cover payments for out-of-network mental health services provided by licensed clinicians?
  • If I have out-of-network benefits, will I be reimbursed the full amount I paid or a percentage? What percentage?
  • Is there a separate deductible for mental health services that are out-of-network, or are in- and out-of-network deductibles combined? How much do I have to pay out of pocket before benefits kick in?
  • Once a deductible is met, what is the dollar amount used to determine how much I will be reimbursed? Typical policies say something like this: “For out-of-network coverage, insurance will pay 70% of the usual and customary fee.”
    Ask “What is the usual and customary fee for an assessment, individual therapy, and group therapy?” then understand that insurance will reimburse you 70% of that amount.
  • For more detail, ask about specific procedural codes for psychotherapy:
    • Do you cover the procedural codes 90791, 90834 and 90837 for individual therapy?
    • Do you cover the procedural codes 90847 and/or 90846 for family therapy?
    • Do you cover the procedural codes 90853 and/or 90849 for group sessions?
    • Do I have telehealth coverage for the procedural codes above with the modifier 95 (i.e. 90834-95, 90837-95, 90846-95, 90847-95, 90853-95, 90849-95)?
  • What is the maximum allowed amount for the above procedural codes?
  • Is any pre-approval required under any circumstances before obtaining out-of-network mental health services to be reimbursed?

Reduced Fees and Financial Aid

CEBT offers reduced fees for services conducted by graduate-level trainees. These services are supervised by our senior staff to ensure quality of care in line with evidence-based practices. To learn more about our reduced-fee services, please contact us.

Emotional Relief Fund logo

In addition, we are proud to partner with the Emotional Relief Fund, which provides financial support to help teens and young adults obtain mental health treatment. To learn more, contact us or visit the Emotional Relief Fund website.

Why we choose to be a private-pay practice

Serving as an in-network insurance provider means accepting financial rules and conditions that aren’t always aligned with the care our clients need.

We have chosen not to seek in-network status because it allows us the freedom to focus on you, without the red tape, for a successful course of treatment. Selecting a private-pay practice like ours carries an additional cost, but you will receive personalized treatment with an expert who is dedicated to helping you.

Other benefits of private-pay practices include:

  • Faster start: In-network providers tend to have the busiest practices, and your first appointment may need to be scheduled weeks or months in advance. Private-pay providers have chosen to operate with more breathing room, meaning they can often see you sooner – and at a time that’s convenient for you.
  • Earlier completion: Owing to our expertise and adherence to evidence-based treatments, most of our clients complete their therapy in 24-26 weeks – a shorter time frame than many courses of treatment. In any case, you and your therapist – not insurance company guidelines – will decide together when treatment is finished.
  • Focus on expertise: Meeting in-network insurance requirements takes time and costs money, which means working faster and seeing more clients. Our practice allows us to follow our passion for more training, education and specialized certifications to better help you.

After all this, your healthcare insurance may still pay for some of the expense. Once you’ve met your insurance deductible, most plans cover a good percentage of the cost to see out-of-network providers. We routinely file claims on behalf of our clients for out-of-network reimbursement, and are happy to do so. What’s more, our services count toward the deductible of typical insurance plans – though you should check into your own coverage.

Cancellation Policy

We require 24 hours notice to cancel a scheduled session without a fee. Cancellations with less than 24 hours notice are charged at the full session rate. This also applies to no show appointments.

Good Faith Estimate

Under the law, health care providers need to provide clients who aren’t using insurance with an estimate of the bill for treatment costs and services. You have the right to receive a Good Faith Estimate for the cost of any non-emergency item or service. CEBT is happy to provide this Good Faith Estimate one business day before your scheduled session. You can also ask us, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

If you receive a bill that is at least $400 more than your Good Faith Estimate for each service, you can dispute the bill. Make sure you retain a copy of your Good Faith Estimate for your records.

For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-985-3059.