Adam J. Shecter
LMSW, MSEd
INSURANCE
I am in-network with Aetna.
If you have out-of-network benefits, I can help you get reimbursed. Benefits often occur after you reach a deductible, which varies from plan to plan. I understand if that is not a possibility for you. But if you can pay out of pocket and/or get out-of-network benefits, please read on.
Talking about money is difficult, especially in the context of therapy.
I am deeply aware of the inequities in the availability and quality of therapy for those who both do, and do not have insurance. Access to therapy is not just an issue of mental health, it is one of social justice.
I attempt to provide an equitable pay scale to my clients and a living wage for myself. I have 3 rates (tiers):
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Tier 1: $100 (Waitlist)
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Tier 2: $175
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Tier 3: $250
If you pay more, it allows me to bring in a client who needs to pay less. If you are out-of-network, I will provide superbills and help familiarize you with the process of getting reimbursed. Click here if you would like to access relevant questions to ask of your insurer when considering out of network benefits.
I use "The Green Bottle" model as a guide for my rates, and encourage you to take a look if you'd like to know more about my pricing criteria. The image below comes from the work of Alexis J. Cunningfolk and Britt Hawthorne.
Questions to ask your Insurance Company
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Does my plan include “out-of-network” coverage for mental health?
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What is my annual deductible for mental health benefits?
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What is my co-insurance?
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Is there a limit on the number of sessions my plan will cover per year?
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Is there a limit on out-of-pocket expenses per year?
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Does my plan require pre-authorization for psychotherapy?
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What is the policy year (i.e. Jan 1 – Dec 31)? This one is particularly important
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What is the reasonable and customary fee (the amount that your plan determines is the normal range of payment within a given geographic area)? In order to find out the reasonable and customary fee, the representative may ask for a Clinical Procedure Terminology (CPT) code for the service you plan to receive. Please note that the CPT codes for services are as follows: 90834 (used for ongoing psychotherapy)