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Getting started!

Rates 


$220 for a 45 min individual therapy session 
Psychological assessment fees may vary depending on referral question and report


I am an out of network provider (Exceptions: *In Network with Original Medicare, OON with Medicare Advantage Plans*).  Depending on your health insurance plan, it is possible for services to be covered in part or in full. Please contact your insurance company to inquire about any "out of network benefits" for teletherapy. If you have out of network benefits, I am able to generate a superbill you can submit to your insurance to assist with reimbursement.

Some questions to consider asking your insurance company:
  • Does my plan include out of network (OON) benefits for outpatient mental health services?
  •  What is my annual OON deductible for mental health services? 
  • Does my OON deductible need to be met before benefits apply? 
  • What is the reimbursement rate in New York City for psychotherapy sessions (Initial session CPT code: 90791; 45 min therapy session: 90834) with a licensed clinical psychologist? 
  • What is my out-of-pocket maximum for OON services?
  • Where do I submit the paperwork to initiate a reimbursement claim?

Good faith estimate(no surprises act)

As of 1/1/22, under Section 2799B-6 of the Public Health Service Act, psychologists and other health care providers are now required by law to give uninsured,  self-pay, and those clients searching for a therapist with a good faith estimate of costs for services that they offer upfront. To learn more about the Act, please visit cms.gov or click here. 

I am a New York State licensed psychologist and provide teletherapy (video sessions) at this time.  As per NY state board for telehealth practice, regardless of state of residence, as long as sessions take place while you are physically located in NY state, that is acceptable.   If you have any questions, please email me. 

Teletherapy note

InSURANCE

*Depends on the treatment received (CPT code) and type of insurance plan
*After your OON deductible has been met, for plans that have OON coverage, insurance companies will reimburse based on a % known as the "allowed amount." 
*Consider inquiring if medical and mental health services both count towards meeting your OON deductible



Example: Your OON deductible is $2,000. 
Your insurance reimbursement rate: 80%
Your insurance company's "allowed amount" for that specific service: $200/session

Once you have met your OON deductible ($2,000), your insurance company will typically reimburse you for 80% of $200 = $160/session. 

Reimbursify is an app that may help you with billing as well, learn more by clicking here. 

HOW DOES OUT OF NETWORK INSURANCE REIMBURSEMENT WORK?

mental health resources

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info@dramishah.com