Understanding Your Out-of-Network Mental Health Benefits: CPT Codes
At Uptown Downtown Psychotherapy, we know that navigating insurance — especially when using out-of-network benefits — can be confusing and frustrating. One of the clearest ways to find out what your plan covers is to ask your insurance company about specific CPT codes.
Common Mental Health CPT Codes
Current Procedural Terminology (CPT) codes are five-digit numbers used by healthcare providers to describe the services they offer. For mental health, common CPT codes include:
90791 — Psychiatric diagnostic evaluation (initial assessment)
90834 — 45-minute individual psychotherapy
90837 — 60-minute individual psychotherapy
90847 — Family or couples therapy, with the patient present
90846 — Family therapy, without the patient present
These codes are essential when contacting your insurance company to inquire about reimbursement rates and coverage for out-of-network services.
Questions to Ask Your Insurance Provider
Call the number on the back of your insurance card and ask the following:
Do I have out-of-network mental health benefits?
What is my out-of-network deductible? How much of it have I met?
What is the allowed amount or reimbursement rate for each of the following CPT codes: 90791, 90834, 90837, 90846, and 90847?
What documentation do I need to submit for reimbursement (e.g., superbill, diagnosis code, etc.)?
Additional questions you may want to ask:
Is there a limit on the number of sessions I can be reimbursed for per year?
Do I need prior authorization for out-of-network mental health services?
We Can Help You Navigate the Process
At Uptown Downtown Psychotherapy, we aim to make your experience as smooth as possible. While we are an out-of-network provider, we are able to submit claims on your behalf, or, if you prefer, we are happy to provide detailed superbills for self-submission.
Our practice administrator is available to help you understand your out-of-network benefits, check your coverage, and answer any questions you may have about the reimbursement process.
Have questions? Contact us — we’re here to support you every step of the way