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Fees and Insurance

I'm a private pay provider.

My sessions are generally 53 minutes long.  Individual sessions cost $400 and Couples/families/partnerships cost $450 per session (Sliding scale available under certain conditions).

 

I offer In-person from my office in Los Angeles, as well as telehealth, via a HIPAA compliant video platform, and phone sessions for

residents of California and/or New York. 

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Preferred method of payment is Zelle, though other options are available. â€‹

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 I provide monthly superbills to individuals who choose to get reimbursed by their insurance, HSA, or FSA programs. Scroll down to the next section for help figuring out if your insurance will reimburse for these out-of-network sessions. Note: Many of my clients do not use their insurance, as they do not want them to have access to what we discuss in our sessions. Please read the No Surprises Act.

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Please reach out via my contact page if you have any questions. 

Thank you, JK

Father and Son
Tips on checking what your insurance might cover
  1. Call your insurance company, membership services/benefits.

  2. Note the date and time you called, ask for a call reference number.

  3. Ask:

    1. Does my plan cover out-of-network psychotherapy providers for outpatient mental health services, specifically when the provider is a Licensed Clinical Social Worker (LCSW)?​

    2. If so, what is the coverage? (Their response is usually framed as a percentage of "the normal and usual rate for the area." My services tend to fall in the normal and usual rate range. You can certainly ask if the fee we agreed upon is within the range allowed). 

    3. Do you cover telehealth (video or phone) and/or in-person visits?

    4. What is my out-of-network deductible? How much of it has been met this year? (Note: The deductible is the amount you must pay yourself before the plan starts reimbursing you their percentage). To see how many sessions you will have to pay fully out of pocket yourself, divide the deductible left by the amount agreed upon for our sessions.

    5. What is my out-of-pocket maximum? (The amount you must pay each year before the plan starts to reimburse you for sessions at 100%).

    6. When do benefits start and renew? (Usually benefits renew either January 1st, or July 1st.  This is when you will have to pay your out-of-network deductible again before your plan starts to reimburse you).

    7. Do you cover CPT codes 90834 and 90837?  (ie, 42-45 min or 53-60 min individual sessions?) Let me know which one they accept. For couples/partners therapy, ask if they cover CPT code 90847. Group sessions are not covered.

    8. Are there any limits to the number of sessions per year allowed?  Is there anything else I should be aware of?

    9. How do I submit my claims to you? (Usually via their website -- remember I will provide a superbill that you can submit once per month).

Tips

Jan-Kees (JK) van der Gaag, MSW, LCSW 

Physical Office for in person appointments is in the Beachwood Canyon Area of  Los Angeles, CA 90068

©2022 by JK Healthy Means Psychotherapy.

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