Why is Mind Therapy Clinic
    Out-of-Network?

    Care first, not just checkboxes

    Insurers often cap visit length or frequency and push one-size-fits-all approaches. We stay independent so your plan is set by your clinician, not by an algorithm or a time limit.

    Clinical freedom for better outcomes

    Prior authorizations and formulary rules can delay or narrow your options. Being out-of-network lets us recommend what’s actually best for you, when you need it.

    More time with you, less time on paperwork

    Insurer billing creates heavy admin work, low/slow reimbursements, and constant back-and-forth time we’d rather spend on your care.

    Transparent pricing and a sustainable practice

    Without insurer rate cuts and months-long payment delays, we can keep an expert team and publish clear fees up front.

    How does insurance still fit in?

    What's Covered

    This is a common question we hear from our clients. Yes, health insurance provides some coverage for psychotherapy. Before you decide to use it, it’s important to know the details to make an informed decision about using health insurance to pay for psychotherapy.

    Currently the California Mental Health Parity Law of 1999 requires that insurers cover specific severe mental health diagnoses to the same extent they cover medical conditions. This translates to more coverage and comprehensive benefits to the following severe mental illnesses:

    • Isolation from friends and family
    • Thoughts of suicide or homicide
    • Distress tolerance
    • PTSD and other trauma-related problems
    • Interpersonal conflict

    The Mental Health Parity and Addiction Equity Act (MHPAEA) of July 1, 2010, mandates mental health benefits to be equal to medical coverage provided by the plan. This covers most plans and requires equal coverage for all mental health and substance abuse diagnoses covered by the plan. However, this law does not apply to individual or small business plans (employers with less than 50 employees). This too allows insurers to limit coverage based on insurances’ definition of medical necessity, and plans to manage therapy visits, authorizing a few sessions at a time.

    We can share simple, step-by-step resources to help you submit claims and track reimbursements. (You pay us directly; your insurer may then reimburse you if you plan includes out-of-network coverage)

    Common Provider Plan Coverage

    Medicare and MediCal

    If you are covered by Medicare or MediCal plans, please take a special note; currently, these plans do not cover the cost of psychotherapy including intensive outpatient programs.

    You can choose a therapist from the “Preferred Provider” or in-network list of your health insurance company or you can choose an out-of-network therapist. The reimbursement rate will be higher if you choose from those preferred by the insurance and will be lower if you choose an out-of-network provider. PPO plans tend to reimburse based usual & customary fees, but the insurance plan determines what fee is “usual & customary” and generally not representative of actual psychotherapy fees.

    You are required to choose a provider who is on your insurance network. Since most skilled, successful therapists don’t take insurance or limit their participation, finding an effective one for you may require some effort on your part. Be sure to check how many sessions are covered by your plan and at what co-pay to make sure that using your insurance feels right to you; weigh the actual financial benefit against the downsides of compromising your privacy, a coverage that may not meet your treatment needs, and restricting your choice of providers.

    We Care About Your Privacy

    At Mind Therapy Clinic, your privacy matters. If you use insurance, we’re required to include a diagnosis and certain clinical details with your claim so your plan can determine coverage. We share only what’s necessary and we never send session notes. If you’d rather keep your care between you and your clinician, you can pay privately; we’ll give you a “superbill” so you can still request out-of-network reimbursement from your plan if it’s offered. Many clinicians remain out-of-network to avoid insurer limits that shorten visits or delay care. If cost is a concern, please ask us about our low-cost therapy options – we’ll help you find a fit.