rates & insurance

We can help you navigate your insurance benefits, both in-network and out-of-network.

We are in-network with the following insurance plans, though each provider’s participation varies based on factors such as specialty, credentialing, licensure, and other requirements. This means the provider who is the best fit for your needs may not always be within your specific insurance network. Our client care team is happy to assist you in confirming provider availability and network status.

• Aetna 
• Ambetter from Superior HealthPlan (Commercial Plans only) 
• Employer's Health Network
• Government Employees' Health Association (GEHA) 
• Optum Behavioral Care
• United Healthcare
• United Medical Resources (UMR)
• Cigna/Evernorth
• SANA Benefits
• Tricare/TriWest/Champus

For other insurance plans and some of our providers, we are considered out-of-network. If you have questions about coverage, our client care team can assist you in determining what portion of your sessions may be reimbursed by your insurance.

• If you have a PPO plan, you can request a statement of services that can be used to submit to your insurance company for reimbursement from your out-of-network mental health benefits.
• Utilizing private pay gives you greater control over your health information as your insurance company will not be given any details of your therapy, and a mental health diagnosis will not be added to your health records (your health record may be used for external purposes such as life insurance eligibility determination). 
• As we are a specialty practice, you can also discuss with your insurance company your eligibility for a single-case agreement (SCA), depending on the service requested and your insurance provider. An SCA works the same as using your in-network benefits if approved. 
• You can also use your HSA or FSA plan to pay for therapy.
• For additional questions, give us a call at 832-559-2622 Mon-Fri 8 am-5 pm or schedule a free consult here. 

• Insurance companies require 3 things to pay or reimburse for counseling: 

  1. an identified client
  2. a mental health diagnosis
  3. evidence of treatment that directly serves the identified client AND a mental health diagnosis considered "medically necessary".

      

• When we work with couples, the diagnostic issue we treat is “problems in the relationship”.  There is a code for this, Z63.0, but most insurers do not cover it as it is not considered medically necessary. Thus, relational concerns are not considered medical concerns.

• Further, let’s say you meet the diagnostic criteria for another mental health condition.  When you come for couples therapy, we are not focused on treating you for that mental health condition.  We are treating the problems in your relationship, and we will assume that you either see an individual therapist for your mental health symptoms OR that your symptoms might lessen over time as your relationship improves. 

  Either way, the treatment we are providing is a research-based form of couples therapy, designed to treat the relationship. Couples therapy focuses on the dynamics and health of the relationship, like reducing conflict or increasing connection, rather than treating an individual with a mental health condition.

• Most of our couples therapists either work from an Emotionally Focused Couples Therapy model or a Gottman Couples Therapy model. Both are wonderful, evidence-supported treatment methods for helping couples; they are not treatments for individual mental health diagnoses.  

• To confirm, call your insurance company and ask specifically, “Do you cover diagnostic code Z63.0 used for marriage/couples/premarital counseling?”

Yes, you may use your health savings account (HSA) or flexible spending account (FSA) to pay for sessions with your counselor. 

No, we do not accept Medicaid/Medicare. You can reach out to those agencies directly for a referral.

Please note that if you have Medicare AND another commercial insurance plan, you must let us know at the time of booking to confirm coordination of benefits with your commercial carrier, as we are not paneled as a Medicare provider.

Rates for therapy vary by therapist based on experience and specialization. 

Rates can be found on each therapist’s profile in our online booking link: https://eddinscounseling.janeapp.com/

• Individual therapy: ranges from $160-$210 per session 
• Couples therapy: ranges from $180-$210
• Group therapy & DBT skills groups: $50 for 60-minute sessions; $75 for 90-minute sessions. 

90-minute individual, couple, and family therapy sessions are also available upon request. Please note that insurance does not cover a 90-minute session. 

Therapy rates are within the fair pricing standards of the Healthcare Bluebook.

Although a therapist may be out of network for your insurance plan, you can request a statement of services that can be used to submit to your insurance company towards your out-of-network mental health benefit, and have any reimbursement paid directly to you.

We send out statements after your appointments by request.

To find out what available coverage you have under your PPO insurance plan, you can call your insurance carrier and ask about your out-of-network mental health benefits.

Questions to ask your insurance company when you call:

• Do I have mental health benefits?
• What is my deductible, and has it been met?
• Do you require pre-approval of services before you will reimburse?
• What is the allowable amount?

Reimbursement Assistance

If you will be seeking reimbursement from your insurance company, we recommend reimbursify – an app to help patients who pay out-of-pocket to get reimbursed by their health insurance.

Once you sign up with their app you can upload the superbills we provide you with to simplify the reimbursement process from your insurance.

Reimbursify will submit your superbills to your health insurance on your behalf.

**If you choose to file with your insurance company, be sure to call the number on your insurance card prior to your appointment to find out your out-of-network benefit details.**

• The first claim is free to submit. You can click here to get a coupon code for 5 free submissions. After that, there is a small fee for them to submit your claims.
• Reimbursify is safe, secure, and HIPAA-compliant.
• Click here to verify your OON benefits and eligibility.

Yes, we do have limited pre-licensed therapists available at a reduced rate depending on your needs and availability. 

As we are a specialty practice, you may request that your insurance plan consider your treatment as in-network through a single-case agreement and reimburse you directly at in-network rates.

This would be applicable for specialty services such as EMDR therapy, DBT therapy, eating disorder treatment, child and play therapy, serious mental illness, etc.

An SCA works the same as using your in-network benefits if approved, but you must request it directly from your insurance company and be approved prior to your visit. 

More information on requesting a single care agreement can be found here. 

• Payment is due at the time of service.
• Visa, MasterCard, Discover, AMEX, personal check, or cash is accepted.
• We also accept Health Savings Account and Flexible Spending Account cards from your employer.
• Career counseling services may be tax-deductible as a “job search” expense if applicable. Ask your career counselor for a statement of services for your tax records.