Payment Options for Therapy Services

Currently, we accept Aetna, Cigna, and Carelon Behavioral Health insurance plans in Washington DC.

In Maryland and North Carolina, we operate on a self-pay basis. Full payment is due at the time of each session. If your insurance plan offers out-of-network benefits, you may be eligible to submit claims for reimbursement and lower your out-of-pocket expenses. Sliding scale rates are also available upon request.

Initial Therapy Call

  • Free: 20-minute consultation call

Initial Diagnostic Assessment

  • Psychiatric Diagnostic Evaluation (60 minutes): $180
    (Required for all new clients)

Individual Therapy Sessions

  • Pricing is based on session duration, with options including 30-minute, 45-minute, 60-minute, and 90-minute sessions.

Couples & Family Therapy

  • 50-minute session: $240

  • 90-minute session: $300

Documentation and Letter Preparation Services

  • Family and Medical Leave Letter: $175

  • Emotional Support Animal Letter (ESAL): $175

  • Schedule A Medical Disability Letter: $175

  • Clinical Diagnostic Evaluation Letter: $175

Guide to Understanding and Using Your Out-of-Network Benefits

Navigating out-of-network benefits can feel overwhelming, but this guide simplifies the process and helps you start receiving reimbursements from your insurance provider.

1. Confirm Your Out-of-Network Benefits

To determine your benefits, start with your insurance provider or employer’s annual Summary of Benefits & Coverage document. While helpful, these summaries can be unclear. A better option is to call your insurance provider directly using the number on the back of your insurance card and ask specifically about your out-of-network benefits for outpatient mental health care.

When contacting your insurance provider, be prepared to provide the following details:

  • Benefit Type: Outpatient mental/behavioral health

  • Place of Service: Office

  • Procedure/CPT Codes:

    • Individual Therapy: 90837

    • Couples Therapy: 90847

Key Terms to Know:

  • Deductible: The total amount you must pay out-of-pocket annually before your insurance begins reimbursing you for out-of-network services. Note: You must submit claims for each session to ensure those payments count toward your deductible.

  • Co-Insurance: The percentage of service fees your insurance reimburses after meeting your deductible. For example, if your co-insurance is 60%, and your session costs $200, you’d receive a $120 reimbursement per claim.

Important Note: Insurance providers often set a maximum allowed amount for specific services. If your insurance caps the reimbursement for a therapy session at $150, they’ll only reimburse 60% of that amount, meaning you’ll receive $90 for a $200 session.

2. Download Your Superbills

A superbill is a detailed receipt that includes all necessary information for your insurance provider (e.g., service codes, duration, provider information).

At Crafting Balance, LLC, superbills are automatically generated each month via our secure client portal, SimplePractice, and emailed to you. Be sure to download and save these for submission.

3. Submit Your Out-of-Network Claims

Submitting claims is the final step to receive reimbursement. There are two ways to do this:

  • Insurance Provider’s Process: Many providers require you to fill out forms, sign them, and submit by mail. However, this method can be time-consuming and cumbersome.

  • Use Reimbursify: Simplify the process with this service, which streamlines out-of-network claim submissions. Learn more at Reimbursify.

Note: Crafting Balance, LLC does not endorse any specific service, as individual insurance plans and experiences vary. However, services like Reimbursify are often more user-friendly than manual submission methods.

By understanding your out-of-network benefits and following these steps, you can reduce out-of-pocket costs and focus on what matters most—your wellness journey.