Cost is one of the biggest reasons people put off therapy. Insurance can help, but the terms can be confusing: in-network, out-of-network, deductible, coinsurance, superbill. This guide explains those terms in plain language so you know what to ask before your first session.
Every plan is different, so the most reliable answer always comes from your insurance company. The goal here is to help you know which questions to ask.
What "In-Network" Means
A therapist is in-network when they have a contract with your insurance company. That contract sets the rate the insurer pays for each session. When you see an in-network therapist:
- You usually pay a smaller share, such as a copay or coinsurance, once any deductible is met.
- The therapist typically submits claims to the insurer for you.
- The amount you owe is based on the insurer's contracted rate, not the therapist's full fee.
Being in-network with one plan from an insurance company doesn't always mean being in-network with every plan that company sells. Employer plans, marketplace (exchange) plans, and other products can use different networks, so it's worth confirming your specific plan.
What "Out-of-Network" Means
A therapist is out-of-network when they don't have a contract with your plan. You can still see them, but:
- You typically pay the therapist's fee at the time of service.
- If your plan has out-of-network benefits, you may be able to submit a receipt (often called a superbill) to your insurer for partial reimbursement.
- Some plans, especially HMO and many exchange plans, have no out-of-network mental health benefits at all.
Yes. Out-of-network clients get a superbill they can submit to their insurance.
How to Check Your Mental Health Benefits
Call the member services number on the back of your insurance card, or log in to your insurer's member portal. Questions worth asking:
- Do I have outpatient mental health (behavioral health) benefits?
- Is [therapist's name] in-network for my specific plan?
- Do I have a deductible for outpatient mental health, and how much of it have I met?
- What is my copay or coinsurance per session after the deductible?
- Do I need a referral or prior authorization for therapy?
- Is telehealth covered the same way as in-person sessions?
- Do I have out-of-network benefits, and how do I submit a claim?
It helps to write down the date, the name of the person you spoke with, and a reference number for the call.
Deductibles, Copays, and Coinsurance
- Deductible: the amount you pay out of pocket each plan year before your insurance starts sharing costs. With a high-deductible plan, you may pay the full contracted rate for sessions until the deductible is met.
- Copay: a set dollar amount you pay per session.
- Coinsurance: a percentage of the contracted rate that you pay after the deductible.
- Out-of-pocket maximum: the most you'll pay for covered services in a plan year. After that, covered services are typically paid in full by the plan.
Deductibles usually reset at the start of each plan year, often January 1, so the same therapy can cost different amounts at different times of the year.
Insurance at Contemporary Behavioral Therapy
Contemporary Behavioral Therapy is a solo practice run by John Campbell, MA, LPC (TX), LPC-MHSP (TN). John offers CBT, DBT, RO-DBT, ACT, and ERP for OCD, in person in The Woodlands / Spring area and by telehealth across Texas and Tennessee. The practice is accepting new clients.
- In-network plans: Aetna, Ascension (SmartHealth), Blue Cross Blue Shield, Carelon Behavioral Health, Cigna and Evernorth, Optum, Quest Behavioral Health, UnitedHealthcare (UHC/UBH), and UMR. Your benefits are checked before your intake appointment.
- Self-pay: Self-pay is $275 for the intake and $225 per 53–60 minute session. A limited number of sliding-scale spots are available, based on household income, for people without mental health insurance. All major credit and debit cards and cash are accepted.
- Skills classes and insurance: Skills classes can be billed to insurance. Coverage depends on your plan, and we'll verify your benefits before you start. The self-pay rate is $100 per 60-minute class.
Current fees and plan details are on the Services and Rates page. If you're unsure whether your plan is accepted, call (713) 955-5925 and we can help you figure out what to ask your insurer.
Frequently Asked Questions
What is the difference between an in-network and out-of-network therapist? An in-network therapist has a contract with your insurance plan, so you usually pay a copay or coinsurance after your deductible and the therapist bills the insurer. An out-of-network therapist has no contract with your plan, so you typically pay the full fee and may be able to request partial reimbursement if your plan has out-of-network benefits.
How do I know if my insurance covers therapy? Call the member services number on your insurance card or check your insurer's member portal. Ask whether you have outpatient behavioral health benefits, whether the therapist is in-network for your specific plan, and what you'll owe per session after your deductible.
Why am I paying the full session cost if my therapist is in-network? If you haven't met your plan's deductible yet, you usually pay the insurer's full contracted rate for each session until you do. After the deductible is met, you typically pay only your copay or coinsurance.
Does insurance cover telehealth therapy in Texas? Many plans cover telehealth therapy, but coverage varies by plan. Ask your insurer whether video sessions are covered the same way as in-person sessions before you start.
Questions? Just Ask
Insurance shouldn't be the thing that keeps you from getting help. If you have questions about using your benefits, reach out or call (713) 955-5925.
This article is general information, not financial or legal advice. Coverage depends on your specific plan; your insurance company is the final source on your benefits. If you are in crisis, call or text 988 or call 911.