Donarski Center for Mental Health Counseling (DCMHC) accepts most insurance plans. Services may be covered in full, or in part, by your health insurance or employee assistance program. Our staff will collect your insurance information and work with our billing department to assist you in determining what your coverage includes.
Due to recent changes in our national health care system, it is nearly impossible for us to verify what services are covered under every client’s plan prior to the appointment. Your insurance may have different coverage for certain specific services. The following CPT codes are for common services here at DCMHC, and may be helpful to ask your insurance provider about when inquiring about your patient portion:
- 90791 Psych. Diagnostic Evaluation:
Used for the first session of therapy/counseling - 90834: Psychotherapy with patient 45 minutes:
Our clinicians’ schedules are structured around 45-minute sessions of therapy/counseling, so a “typical” session of individual therapy will likely be billed as 90834 - 90837: Psychotherapy with patient 60 minutes:
When a session of individual therapy runs longer than expected (closer to an hour instead of 45 minutes), the session will likely be billed as 90837 - 90847: Family Psychotherapy with patient present:
When the primary patient of therapy is accompanied by a family member for their session (e.g., marriage therapy, family therapy, reunification therapy, parental involvement during sessions with a child, etc.), the session will likely be billed as 90847 - 90846: Family Psychotherapy without patient present:
When the primary patient of therapy is not in attendance, and the clinician is instead working solely with a family member for the session (e.g., parent-skills training sessions), the session will likely be billed as 90846
Please note that while these are the most commonly used CPT codes for billing purposes, the above list is not a full list of all CPT codes that may be used for billing purposes. Prolonged outpatient visits have varying and add-on CPT codes depending on the circumstances of the appointment lasting over one hour. An add-on code is used to represent an additional procedure/service that is provided in conjunction with a primary procedure.
We do recommend that all clients reach out to their insurance providers to inquire about their Behavioral Health / Mental Health coverage details. The following questions may be beneficial to ask when speaking to your insurance representative:
- Do I have mental health insurance benefits?
- Does my coverage include the CPT code <insert CPT code from above listing>?
- What is my deductible and has it been met?
- How many sessions per year does my health insurance cover?
- What is the coverage amount, co-insurance amount, and copay per therapy session?
Insurance companies require us to collect copay and deductible amounts on the day of service; Insurance companies do not cover No-Show fees. We accept credit card, debit card, HSA card, check, and cash payments. If you have your appointments as “telehealth,” you will be asked to put a card on file for DCMHC to charge the card after each appointment. If you do not want a card on file, it is your responsibility to call the office to make the copay payments immediately following your therapy session. If you do not do this, it may result in added “late-fees.”
Clients may notice on certain billing-related documentation that a provider is listed who is not their direct clinician (i.e., Shannon Groh, LPC; Edwin Vergara-Mego, LPC; Janene Donarski, PhD). Sometimes this happens due to insurance requirements. Please reach out for further information or questions.
If you have any questions regarding the insurance policies at DCMHC, please contact us at billing@donarskicenter.com.