Starting Therapy and Cost
Using Out-of-Network Benefits for Therapy in New York
What out-of-network benefits are, how superbills work, and the questions worth asking your plan before you start.
What out-of-network means
Carter Cares is a private pay practice, so we are not in any insurance network. Some plans still offer out-of-network mental health benefits, which may repay part of what you spend on therapy. Whether your plan does, and how much, depends entirely on the plan you have.
What a superbill is
A superbill is a detailed receipt with the information an insurer usually asks for, such as session dates, fees and service codes. You pay for the session, then submit the superbill to your plan yourself. Your plan reviews the claim and decides whether to reimburse any portion of it.
Questions to ask your plan
Call the number on your card and ask: Do I have out-of-network outpatient mental health benefits? What is my deductible, and how much has been met? What percentage do you reimburse after the deductible? Do I need preauthorization? How do I submit claims, and is there a deadline?
Thrizer as another option
Carter Cares partners with Thrizer, a platform that helps clients use out-of-network benefits. Thrizer can show an estimate of your benefits, handle payment, submit supported claims and track reimbursement. Eligible clients may also choose Thrizer Pay and cover an estimated out-of-pocket amount per session rather than the full fee.
When this is worth exploring
Checking benefits is worth the phone call if you want weekly therapy and cost is a real factor. HSA and FSA accounts may also apply, so ask that plan what it allows. The details of each choice are on Rates and Insurance, and we can talk about them during a free consultation.
What I will and will not promise
I can provide superbills and explain how Thrizer works. I cannot tell you what your insurer will pay, because your plan makes the final decision on coverage and reimbursement. Treat any estimate as an estimate, and plan for the full session fee unless your plan confirms otherwise.
Questions About This Topic
Does Carter Cares bill my insurance directly?+
No. We are private pay. You can submit superbills yourself or use Thrizer to submit supported claims.
Will I definitely be reimbursed?+
Not necessarily. Your insurer decides coverage and reimbursement, so no amount can be promised in advance.
Can I switch between superbills and Thrizer?+
Ask about it during your consultation, and we can talk through which option seems simpler for you.