Important Information

Patient has a commercial insurance as primary, and a Medicaid plan as secondary. We will show the regular benefits with patient’s commercial insurance, but understand the following:

• If patient’s care goes to the commercial insurance’s deductible, Medicaid will cover the charge at the Medicaid allowed amount (for mental health counseling services).
• If patient has co-insurance or a co-pay due with commercial insurance, we will follow the co-pay amount for Medicaid instead.

Insurance Coverage for these codes:
90791 - Psychiatric Diagnostic Evaluation
90832 - Individual Psychotherapy 16-37 minutes
90834 - Individual Psychotherapy 38-52 minutes
90837 - Individual Psychotherapy 53 minutes plus
90785 - Interactive Complexity
90846 - Family Therapy without patient 26 minutes plus
90847 - Family Therapy with patient 26 minutes plus
90853 - Group psychotherapy (interpersonal processing)

Disclaimer
When we call on a patient's insurance and verify benefits it is not a guarantee of payment by the insurance company and may vary according to the patient's individual plan when the actual claim is submitted. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member's contract at time of service. The patient responsibility amount provided is an estimate of cost. The patient must understand that their health insurance company may deny payment for the services received. The patient must understand that it is ultimately the patient's responsibility to contact their insurance if they want to know exact benefits.