Is marriage counseling or sex therapy covered by insurance?

 

Please read this entire section before calling for an appointment.

 

 

If you are interested in seeing me for marriage counseling, sex therapy, or online therapy, you must call your insurance company if you want to know if your sessions will be covered. While some of the more expensive plans cover theses services, many affordable plans do not. You should never assume either way.

 

When you call your insurer, DO NOT use the words “marriage” or “couples,” or they will give you inaccurate information. Tell them that the service code is 90837 and give them one of the following diagnostic codes. These two codes are the only information that I give them when I file claims.

 

 

  • Marriage or couples counseling:  Z63.0.
  • Low sexual desire:                          F52.22
  • Erectile Disorder                            F52.21

 

 If one of these codes is not covered, your insurance company representative will normally advise you to ask me to code the diagnosis as Major Depression or an anxiety disorder. However, the people who give this advice often neglect to consider that I have to be honest when I file insurance claims for legal reasons.

 

What insurance plans do you accept?

I accept Tricare, Anthem and other forms of Blue Cross Blue Shield, although I DO NOT accept Healthkeepers. I currently accept Cigna, but this will end on December 11, 2018. Cigna and United Healthcare often pay for out-of-network services. You will need to call your insurer to check on this benefit before coming to see me.

 

Is Teletherapy covered by Insurance?

 

 To find out if your insurer pays for Teletherapy, call them and ask if they cover “Place of Service code 02” along with “CPT code 90837”.

 

How much do you charge?

 

If I am in your network, and your diagnosis code is covered by your insurer, you will only be responsible for a copay and possibly co-insurance, assuming that your deductible has been met. If it is not covered, my fee is $140 per session. I never charge for both members of a couple. I will always work to make therapy as efficient and effective as possible, and I will strive not to waste your time or your money.

 

 Does Marriage Counseling Work?

 

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