Insurance Support

Do you take insurance?

‍We are in-network with Aetna, Cigna and Northwell Direct in New York and Colorado. We are in-network with United and Optum in Colorado. We are an out-of-network provider for all other plans.

Most insurance plans provide out-of-network benefits and we’ve found that most of our clients who have a PPO are able to get 50-80% of each session reimbursed after meeting the deductible.

FSA / HSA

Do you work with FSA/HSA?

Yes. Flexible spending accounts and health savings accounts allow you to set aside money before taxes for medical expenses. You can apply those funds to each appointment with us.

Pricing

Need More Answers?

How do I verify my insurance coverage?

To verify coverage, call the member services number on the back of your insurance card.

For Aetna, Cigna, or Northwell Direct, provide our Type 2 NPI: 1285006353.

For United or Optum, provide the insurance representative with the appropriate Type 1 NPI:
1710012182 for New York
1972135184 for Colorado

What is the difference between the CPT codes 90791, 90837 and 90834?

CPT codes are billing codes used by all healthcare providers to describe the type of service provided. You may see them on your statements, superbills, or insurance claims.

90791 is used for the intake session where your therapist gathers background information, reviews your history, and develops a treatment plan. It is usually scheduled as your intake session.

90837 is used for all subsequent therapy sessions, typically around 53–60 minutes.

90834 is used for occasions when a session is less than 53 minutes.

Do I get a Good Faith Estimate (No Surprises Act)?

You will receive a Good Faith Estimate (GFE) through our patient portal only if you are not using insurance to pay for sessions. The GFE outlines the expected costs of your care and is required under the No Surprises Act for clients who are uninsured or choosing not to use their insurance benefits.

How do copays, coinsurance, and deductibles work?

A copay is a fixed amount you pay at each session, for example $20 or $40. It is set by your insurance plan, not by our practice. Your deductible is the amount you must pay out of pocket each year before your insurance begins covering services. For example, if your deductible is $1,500, you are responsible for the insurance contracted rate until you have paid $1,500 in covered medical expenses that year.

After meeting your deductible, you may pay coinsurance, which is a percentage of the session fee (for example, 20 percent), while your insurance covers the rest. This percentage is determined by your plan.

The best way to confirm your responsibility is to call the member services number on your insurance card and ask specifically about your mental health or behavioral health benefits. Give the representative the CPT code 90837 and our NPI number. Ask: “What is the contracted, or allowed, amount for this code with this provider?” Your insurer should be able to tell you the contracted rate and whether you owe a copay, coinsurance, or deductible amount.

How and when do I pay?

Your card is charged after the session, usually within 48 hours.

How do out-of-network benefits work?

If we are not in network with your insurance plan, you may still be able to use your out-of-network (OON) benefits. Here is how it works:

You pay our full session fee at the time of service. Upon request, we can generate a superbill (an itemized receipt with the necessary CPT and diagnosis codes) and upload it to your secure client portal each month. You then submit this superbill to your insurance company. If you have OON benefits, your insurer may reimburse you directly for a portion of the session cost. Reimbursement amounts and timelines vary depending on your plan.

When calling your insurer, it helps to ask:
- Do I have out-of-network mental health benefits?
- Are CPT codes 90834 (45-minute psychotherapy) and 90837 (60-minute psychotherapy) covered?
- What is my out-of-network deductible and how much of it have I already met?
- After meeting my deductible, what percentage of each session will be reimbursed?
- Do I need a referral or prior authorization for out-of-network psychotherapy?
- Where and how do I submit claims or superbills for reimbursement?

Do you offer a sliding scale or financial assistance?

Some of our therapists offer a sliding scale when available. Please speak with your therapist directly to inquire about their availability.

Do you charge for late cancellations or no-shows?

Yes. If you need to cancel or reschedule, you must do so at least 48 business hours in advance (Monday–Friday, 10:30 am–6:30 pm ET). If you cancel with less than 48 business hours’ notice or do not attend your appointment, you will be chargedthe contracted rate. We cannot bill your insurance for late cancelations or no shows and they are not the same amount as your copay or coinsurance.

From questions about costs to what to expect from our therapy, we’re here to answer. You can Email Us (billing@createoutcomes.com) or speak to a member of our billing team at 866-232-7328