Rates & Navigating Out-of-Network Insurance Benefits

No, I am an out-of-network provider. I can provide a superbill to submit to your insurance company for reimbursement if your plan has “out-of-network” benefits. I accept all major credit cards, HSA & FSA cards for payment at the time of service.

Many clients are surprised to find that their insurance plan does have out-of-network benefits.

During our free consultation call, I can check if your insurance plan has out-of-network benefits, your OON deductible, and the estimated percentage you will be reimbursed.

Payments are eligible for payment plans.

I am choosing to opt out of partnering with insurance companies as they are part of broader systems that have deep structural problems affecting cost, access, quality, and equity. U.S. health insurance is profit-driven, and tied to employment rather than designed as a universal public service. What insurance covers is limited and restricted to uphold the maximizing of benefit to insurance companies.

Insurance companies tend to reimburse therapists at very low rates (as low as $40 per session), and it is difficult to sustain a practice with these rates. Billing insurance comes with extensive paperwork and administrative demands that require hours of additional labor. This reduces the number of clients a therapist can see or requires paying additional staff to handle this work. When therapists and private practice owners take insurance, they often have to hold a caseload of 30-40 clients per week just to cover costs.

I am able to provide mindful, grounded, emotionally attuned, and high quality care when I am not pressed to overload or burn myself out. For each client, I do prep work involving additional research outside of appointment times, I bring intentional presence, energy resonance, and grounded nervous system co-regulation to our sessions. By offering sliding scale fees based on financial needs, I’m able to keep services more accessible without the added administrative burdens of working with insurance companies.

Out-of-network benefits are part of some health insurance plans that help cover the cost of care you receive from providers who are not in-network with your insurance company.

Many insurance plans offer out-of-network benefits, however reimbursement rates vary. Typically clients have to meet their out-of-network benefits deductible in order to start receiving reimbursements. 

The best way to know if your insurance plan offers out of network coverage is to call the number on the back of your insurance card.

Helpful questions to ask:

• Does my plan include “out-of-network” coverage for mental health?

• What is my annual deductible for out-of-network mental health benefits? 

• What is the coverage limit on the number of sessions my plan will cover per year? 

• Does my plan require a referral or pre-authorization for mental health services?

• What are the out-of-pocket costs or copays that count towards my out-of-network (OON) deductible? (i.e. monthly prescription medications)

  • Our appointments count towards your OON deductible.

• What is the reimbursement percentage rate for specific mental health services? (CPT codes listed below under “allowed amount” tab) 

  • What is the “allowed amount” for these specific services? (CPT codes)

Thrizer is a platform designed to make therapy more affordable by helping clients optimize their out-of-network insurance benefits. 

Instead of clients having to fill out and submit superbills to their insurance provider, Thrizer files claims on their behalf. This increases the chance of clients getting reimbursed and saves time. You can use Thrizer to check your out-of-network benefits and estimates how much you could get back per session. They typically charge either a per-claim fee or a subscription.

Thrizer reduces costs upfront once you meet your deductible, you can often pay only your co-insurance amount at the time of the session, instead of the full therapist rate. Thrizer pays the rest up front and waits for the insurance reimbursement.

This process often saves clients hundreds or even thousands of dollars across many sessions and removes the typical weeks-long wait for reimbursement.

Click this link for more information: https://www.thrizer.com/for-clients

Thrizer provides the option to pay the full rate up front, submit a superbill, and wait for reimbursement from your insurance company or pay only your co-insurance amount after you’ve met your out-of-network (OON) deductible.

Co-insurance rates depend on your plan’s “allowed amount” and reimbursement percentage for out-of-network services.

Some co-insurance amounts range from $40 - $110 per session for 60 min Individual Therapy depending on your plan.

For example: If the therapist’s rate is $170 but your plan’s “allowed amount” is $120 and their reimbursement rate is (50%) you would pay $110. Insurance only reimburses their set percentage of what they determine is the “allowed amount.”

50% of $120 is $60

$170 - 120= $50

$60 + $50 = $110

If the therapist’s rate is $170 and your plan’s “allowed amount” is $165 and their reimbursement rate is (60%) you would pay $71.

At (70%) reimbursement rate, you would pay $52.50

At (80%) reimbursement rate, you would pay $38

“Allowed amount” is the rate your insurance company determines is the reasonable and customary cost of a service, specified by CPT code and zip code.

For accurate information, call the customer service phone number on the back of your insurance card. The representative may ask for the CPT code (Clinical Procedure Terminology) and zip code of the therapist or general geographic area (ie. Chicago, IL).

Here are the CPT Codes for services at this practice:

90791 Intake Diagnostic Evaluation 60 min

90837 Psychotherapy 60 min

90834 Psychotherapy 45 min

90832 Psychotherapy 30 min

90853 Group Psychotherapy

90785 Interactive Psychotherapy

The No Surprises Act is a federal law that protects you from unexpected or confusing medical bills. For therapy, this means that if you are uninsured or paying out of pocket, you have the right to receive a Good Faith Estimate.

A Good Faith Estimate is a document that explains how much your therapy sessions are expected to cost before you begin treatment. It includes the price per session and an estimate of your total costs. This helps you understand and plan for your care with no surprise bills later.

Individual Therapy, Somatic Therapy, Art Therapy, EMDR Processing Sessions

I offer 30 min, 60 min, or 90 min sessions, rates range from $125 - $220.

30 minute session  -  $115

60 minute session -  $170

90 minute session - $225

Intake Diagnostic Evaluation - $220

Sliding scale options are available, please contact me for more information.

*Pro bono spots are currently filled

I am open to scheduling weekly, bi-weekly or monthly sessions, as determined clinically appropriate.

EMDR Intensive Processing Sessions

2 hour session - $300

3 hour session - $450

4 hour session - $600

Clinical Supervision for LPC & Pre-Licensed Therapists

Individual Supervision - 60 minutes - $100

Group Supervision - 2 hours once per month- $60

For Clinical Supervision Inquiries - please contact me directly at

kate@dragonflyalchemycounseling.com

Queer ADHD Support Group Online

Group is offered at a standard fee of $20 per session.

I offer a reduced rate for community access of $15 and low fee spots of $10.

Dragonfly Alchemy requires at least 48 hours notice to cancel or reschedule an appointment. Sessions cancelled with less than 48 hours notice will be charged the full session fee, as this time is reserved specifically for you.

Clients may cancel up to two sessions per year for any reason with no charge.

Each session involves intentional preparation, emotional attunement, grounded energy resonance, and nervous system co-regulation. Holding this dedicated space ensures you receive focused, high-quality care.