Kaerensa Craft, LCSW, PSYCHOTHERAPY

NY, NY | Montclair, NJ

PAYMENT AND INSURANCE

My standard fee for psychotherapy is $250 per 45-minute session, though I do offer a “sliding scale,” with an amount per session to be agreed upon following discussion about need and resources.

Coaching sessions are $250 per 45 minute session. Packages of four 60-minute sessions can be purchased in advance for $850.

INSURANCE

Please note that while most insurance plans cover psychotherapy, insurance does not provide coverage for coaching sessions.

I currently am an in-network provider with Oxford, UnitedHealthcare (UHC), Optum and OSCAR. Unfortunately, I am not in-network for Community Plans administered through UHC.

For all other insurance plans, I am an “out-of-network” provider, which means that your insurance plan must include out-of-network mental health benefits (also referred to as “behavioral health” benefits) to cover services with me. If you are not sure about whether your plan has out-of-network benefits, please contact the number on the back of your insurance card to ask the questions below.

For both in-network and out-of-network plans, I will submit claims on your behalf.

FOR OUT-OF-NETWORK PLANS: QUESTIONS TO ASK YOUR INSURANCE REPRESENTATIVE

Do I have out-of-network benefits?
What is the cost of my deductible before my plan starts paying on out-of-network services?
Is my deductible for mental health/behavioral health separate from my deductible for physical health, or is the deductible combined?
Do I have an in-network deductible as well, and if so, does that count toward my out-of-network deductible?
How much of my deductible has already been met?
What is my out-of-pocket maximum, and does my deductible count toward the out-of-pocket maximum?
a. Does my plan reimburse a flat rate for out-of-network services, or is it a percentage of the provider’s fees? (If a flat rate, what is the amount? If a percentage, what is the percentage?)
b. If my plan reimburses at the “Usual-and-Customary” rate, up to what amount is allowed? (The insurance representative may ask for the following in order to tell you if your plan covers it: The procedure code, also known as the CPT code, is 90834 for individual therapy, and 90847 for family therapy. The provider’s fee: $250. The provider’s licensure: LCSW. The provider’s National Provider ID (NPI): 172-010-3807. The Place of Service code: 11. The zip code: 10010.)
Does my plan require pre-authorization? (If yes, you should request authorization at this time. If needed, my National Provider ID (NPI) number is 172-010-3807. The procedure or CPT code for a 45-minute individual psychotherapy session is 90834.)
Does my plan require periodic re-authorization? (If yes, you should ask how many visits the initial authorization covers so that you will know when to request re-authorization for additional visits.)
Where do I need to send claims for reimbursement?