How much does therapy cost with blue cross blue shield

Índice Show

Getting Started
Treatment Options
Find a Behavioral Health Provider
Additional services
Is therapy ever covered by insurance?
Does Blue Cross Blue Shield Florida cover therapy?
What are the 3 types of therapy?
Are therapists worth it?

We help clients use their out-of-network insurance benefits to cover the cost of therapy.

If you have BCBS insurance, you most likely have out-of-network benefits. You also mostly likely do not need pre-approval for a 45 or 60 minute psychotherapy session, and there is no limit to the amount of sessions you can have in a year.

Blue Cross/Blue Shield PPO

BCBS will typically cover 70% of their customary rate or allowed amount for out-of-network coinsurance reimbursements. While some plans set the allowed amount at an artificially low rate ($83 for a 45 minute meeting), other plans use the usual and customary rate ($275 for a 45 minute meeting, and $310 for a 60 minute meeting). To find out what the allowed amount for your specific plan is, please speak to your insurance company.

Here’s an example of what this looks like using the Fair Health Consumer website to calculate expenses for a 45-minute session. This is a useful tool to provide you with an estimate of your healthcare expenses.

70% of the usual and customary fee means that they will pay $175 of a $250 fee, making the out of pocket cost $75 after reimbursement.

We have also seen out-of-network deductibles range from $1,500 – $2,800 depending on the plan.

Highmark Blue Cross/Blue Shield

Highmark BCBS will typically cover 60% of the usual and customary rate or allowed amount ($250 for a 45 minute meeting, and $300 for a 60 minute meeting).

Here’s an example of what this looks like using the Fair Health Consumer website to calculate expenses for a 45-minute session.

60% of the usual and customary fee means that they will pay $150 of a $250 fee, making the out of pocket cost $100 after reimbursement.

We have also seen out-of-network deductibles range from $1,000 – $3,000 depending on the plan.

*BCBS Payer ID for electronic submissions is 00803

To receive an approximate estimate of what you can expect to pay for therapy, enter your information into our Insurance Benefits Calculator. You can download and email us this information and we will cross-verify your benefits on your behalf.

You know that your benefits offer mental health services, but you may have questions about what your plan covers or what type of provider you can see for your behavioral health care. We're here to help you make informed decisions when searching for behavioral health providers and how to access the type of care and support you need.

If you are looking to learn more about specific behavioral health conditions, treatment, and support options, you can do that and more at our Behavioral Health Center under ahealthyme.

When to Seek Treatment

Getting Started

When you start looking for behavioral health services, it is always a good idea to first speak with your doctor who serves as your primary care provider (PCP). Your PCP knows you and your health best, and will be able to help you by:

Determining if you have a behavioral health problem
Determining if you can be treated in a PCP setting, or require a specialized provider for your behavioral health needs
Refer you to a behavioral health provider with whom your PCP may have a relationship or who may practice in your PCP's office
Collaborate with behavioral health providers in the event that the PCP feels you need specialized care

Please note: Regardless of your coverage, you do not need a referral for behavioral health services.

Treatment Options

Treatment depends on several factors—including the type of symptoms and degree of severity—and is determined by what works best in each situation. In many cases, a combination of treatments, such as psychotherapy and medication, is the most effective. If you are experiencing a mild behavioral health condition, one form of treatment will often suffice.

Outpatient Therapy: Outpatient counseling, the most common service in behavioral health, is provided by independently licensed behavioral health providers. Typically, they see patients in a private office located at a health care facility, clinic, professional building, or home. The frequency of outpatient visits varies and is based on a patient's individual needs and the behavioral health provider's professional opinion.

Counseling and Psychotherapy (Talk Therapy): Sessions with a licensed professional that provide you with strategies for dealing with your thoughts, feelings, and behaviors. If you would like to get counseling, you can use our Find a Doctor tool to help you select a counselor.
Medication: Your PCP, as well as a psychiatrist and a psychiatric nurse practitioner, can prescribe medication to treat behavioral health conditions.. You can choose to see a behavioral health professional for counseling or psychotherapy, while also seeing a psychiatrist or psychiatric nurse practitioner for medication and counseling services. Your behavioral health providers will be able to explain your treatment options.

Find a Behavioral Health Provider

Selecting the right behavioral health provider can be a challenge. These types of practitioners use varying titles, which can be confusing. We're here to help by providing summaries of what certain behavioral providers can offer:

Licensed Independent Clinical Social Worker (LICSW): A licensed social worker with a master's degree who can offer individual therapy, couples therapy, family therapy, or group therapy.
Licensed Mental Health Counselor (LMHC): A licensed counselor who can offer individual therapy, couples therapy, family therapy, or group therapy.
Licensed Marriage and Family Therapist (LMFT): A licensed therapist with a master's degree who can offer individual or group therapy and has specific training in working with couples and families.
Psychologist: According to the American Psychological Association, a psychologist must have a doctoral degree in psychology. Psychologists can offer individual therapy, couples therapy, family therapy, or group therapy. They are also trained in psychological testing and some in neuropsychological testing.
Psychiatrist: A psychiatrist is an M.D. with specialized behavioral health training. Psychiatrists can prescribe medications for behavioral health treatment, and they may offer individual therapy, couples therapy, family therapy, or group therapy. Child psychiatrists have specialized training in treating children.
Psychiatric Nurse Practitioner: An advanced practice nurse who provides a wide range of behavioral services for patients and families. Psychiatric nurse practitioners have been specially trained to prescribe medication to patients with behavioral health diagnoses.

With our Find a Doctor & Estimate Costs tool, you can search for the right behavioral health specialist for your health needs and your specific plan coverage. Simply log in to MyBlue or create an account to conduct personalized searches.

To learn how to use Find a Doctor & Estimate Costs, download a step-by-step guide.

Additional services

A behavioral health provider will work with you to determine the right course of treatment for your condition. In some cases, this may mean additional services such as:

Intensive Outpatient Programs: This type of program is usually administered at a health care clinic. The program runs for three to five days a week, and includes three to four hours of individual and group therapy that addresses:
- Psychological and social assessments
- Monitoring and treatment planning
- Education and counseling on maintaining recovery

Partial Hospital Programs: This type of program usually takes place at a dedicated clinic, with sessions five to seven times a week. The sessions usually include six to eight hours of individual and group therapy that addresses:
- Psychological and social assessments
- Monitoring and treatment planning
- Education and counseling on maintaining recovery

If you have questions about your coverage or finding a behavioral health provider, call us at the number on your Blue Cross ID card.

Is therapy ever covered by insurance?

Health insurance typically covers therapist visits and group therapy. The level of coverage will vary based on your insurance provider and plan. Additionally, since insurance only covers “medically necessary” services, some insurance companies may require a mental health diagnosis before they will pay claims.

Does Blue Cross Blue Shield Florida cover therapy?

When you see a therapist who is in-network with Blue Cross Blue Shield, each session you'll pay only a copay, which typically ranges from $0-$75/session.

What are the 3 types of therapy?

Approaches to psychotherapy fall into five broad categories:.

Psychoanalysis and psychodynamic therapies. ... .

Behavior therapy. ... .

Cognitive therapy. ... .

Humanistic therapy. ... .

Integrative or holistic therapy..

Are therapists worth it?

Some research shows that psychotherapy (also known as talk therapy) is effective for up to 75% of people. It can improve the behaviors and emotions that are negatively impacting your mental health. It also results in less disability and fewer sick days, which might be able to offset the actual cost for some people.