Out-of-Network & Superbills

Out-of-Network Therapy & Superbills: What You Need to Know

Sometimes the best therapist for you isn't in your insurance network. That doesn't mean you're out of options — and it doesn't always mean paying full price.

What does "out-of-network" mean?

An out-of-network therapist doesn't have a contract with your insurance company. You typically pay the full session fee upfront, but you may be able to get reimbursed for a portion of the cost through your insurance.

What's a superbill?

A superbill is a detailed receipt your therapist provides after each session (or monthly). It includes the information your insurance company needs to process a reimbursement claim:

  • Therapist's name, credentials, and NPI number
  • Diagnosis code (required by insurance)
  • CPT code (the type of session)
  • Date of service and fee charged

How reimbursement works

  1. You pay your therapist directly at the time of service
  2. Your therapist gives you a superbill
  3. You submit the superbill to your insurance company
  4. Your insurance reimburses you a percentage (often 50–80%) after your out-of-network deductible is met

How to check your out-of-network benefits

  • Call your insurance and ask specifically about "out-of-network outpatient mental health benefits"
  • Ask about your out-of-network deductible (it's usually separate from your in-network deductible)
  • Ask what percentage they reimburse and what their "usual and customary" rate is

Services that can help

Tools like Reimbursify or Mentaya can automate the superbill submission process for a small fee, making out-of-network therapy much more manageable.

When going out-of-network makes sense

  • You need a specialist (e.g., EMDR, specific populations) who isn't in-network
  • You've had a bad experience with in-network providers
  • You want more privacy (out-of-network therapists have less insurance oversight)
  • You value the therapist fit more than the copay savings