Insurance and Fees

Gifted youth

What are the advantages of self-pay for therapy?

Choosing self-pay allows for more privacy and choice in format of treatment. Please be aware of the following for insurance: 

  • Insurance companies require you to authorize us to provide them with a clinical diagnosis of a mental health disorder.
  • When using your in-network insurance benefits the insurance company has the right to access clinical information such as treatment plans and summaries or copies of the entire record. Therapy records may become part of the insurance company's record. 
  • Insurance companies may regulate the frequency, number of sessions or length of counseling session. Self-pay gives you more choice in your course of treatment and allows you to choose which therapist you see.
  • Insurance may limit which types of issues you may receive services for. Insurance will only cover mental health services deemed medically necessary.
  • Marriage counseling is not considered mental health treatment and not covered by most insurance plans.

  

In choosing self-pay clinical diagnosis and copies of your medical record will not be accessible to your insurance company and be kept confidential as allowed under Ohio law. Self-pay allows you to receive psychotherapy for what you feel is important without it being determined as medically necessary by an insurance company. It gives you more control over your privacy, which services you use, what clinician you see and the frequency that you you see them.   

May I use my HSA account for therapy?

Yes, you may use your HSA account to pay for mental health care. Although most services qualify as mental health treatment, there are some exceptions like coaching and marriage counseling which are not considered medical expenses.

What about EAP benefits?

An Employee Assistance Program (EAP) is a work-based program that may offer free or discounted mental health assessments, short-term counseling, referrals, and follow-up services to employees who have personal and/or work-related concerns. EAPs differ greatly depending on the employer and are not offered by all employers. The provider list for EAP programs can also differ from your insurance company's provider list. Please check with your human resources or EAP department to inquire about the specific benefits offered by your employer and if your provider will be covered under these benefits.

Are all services covered by insurance?

Many health insurance plans cover mental health care, but each plan is different. You need to contact your insurance company to find out the specific benefits of your plan. Insurance plans that do offer mental health benefits only cover services considered medically necessary.


Psychotherapy, counseling, and coaching for clients who do not meet the criteria for a mental health diagnosis are typically not considered mental health care, and therefore, not covered by health insurance. Marriage/Couples counseling is not considered mental health care by most insurance plans and not typically covered by insurance. Family counseling is only considered medically necessary when it is to support a family member who is in treatment with an identified with a mental health disorder. Consultations are not covered by insurance.

What are the fees?

Most appointments cost $100-$125 per session. Psychotherapy and clinicial counseling is customarily $125 per session, while most consultation and coaching sessions are $100. Some services including but not limited to diagnostic evaluations are higher. Please review the Consent for Treatment on the forms page for a detailed listing of fees and more information on billing. 

What if I choose to use my insurance benefits?

Many insurance plans have both in-network and out-of-network benefits that cover mental health services. However, insurance benefits and network providers vary. Therefore, it is important for you to contact your insurance company directly to find out specifics for your individual plan and if your provider is in-network at the location you are planning on seeing them. 


Christy Pulsford MSW, LISW-S, LICDC is an in-network provider for some insurance plans. Her license, training and education also qualify for out-of-network reimbursement for many companies she has not contracted with. This means that insurance plans may allow members to go out-of-network for mental health services and will reimburse the you for a portion of  the service fees, according to the payments they allow. Please check the nature of your insurance and what it will reimburse you.  


If you choose to use out-of-network benefits we will be happy to provide a CPT code and Statement of Insurance Reimbursement  to assist you in submitting claims.  Another option is to use a service like Better to file a claim. Please remember insurance companies will only reimburse if they deem it medically necessary and are provided with a clinical diagnosis. Also, every insurance plan is different and you are strongly advised to contact your insurance provider in order to better understand your mental health benefits and coverage. 


If coverage is denied due to lack of authorization or a claim adjustment is determined by your insurance carrier, you will be responsible for the full service fee. In addition, you will be responsible for any fees not reimbursed by the insurance company within 60 days of the the claim being filed. It is advisable that you ask your insurance provider if you have a deductible that needs to be met before benefits are provided, and if your insurance limits you to a certain number of sessions per year. 


Payment, co-pays, and/or deductibles are due at the time of service.  If using out-of-network benefits you are responsible for the entire fee at time of service. We accept payment in the form of health savings accounts (HSA), VISA, MasterCard, Discover, and American Express.


Click below to find out more information on the on In-Network, Out-of-Network, Self-Pay and the service Better.

Please be aware that Christy Pulsford uses telehealth including but not limited to phone, email and text. By scheduling an appointment, using the client portal or contacting Christy Pulsford you consent to receiving information from Macks Psychology Group and GrowthINsight Counseling LLC via email, phone and text. This includes but isn't limited to email replies, appointment reminders, scheduling instructions and delivery of forms and consents.