Insurance and therapy have a complicated relationship, and the vocabulary does you no favors. In-network, out-of-network, superbills, allowed amounts, deductibles. Here’s what all of it actually means in plain English, and how Colorado clients routinely get a meaningful share of their therapy costs reimbursed.
In-Network vs. Out-of-Network
An in-network therapist has a contract with your insurance company. You pay a copay, the insurer pays the rest, and the therapist works within the insurer’s rules and rates.
An out-of-network therapist, like the clinicians at Full Bloom, doesn’t contract with insurers directly. You pay the session fee yourself. Then, if your plan includes out-of-network mental health benefits, your insurance reimburses you for part of it afterward.
Why Many Therapists Are Out-of-Network
It’s not about avoiding paperwork. Working outside insurance networks means your therapist decides how long sessions run, how many you need, and what approach fits you, rather than an insurance company making those calls. It also means you don’t need an insurance-mandated mental health diagnosis on your permanent record just to access care, and your clinical information stays between you and your therapist.
Out-of-network doesn’t mean out of reach. Many of our clients are reimbursed for a significant portion of every session.
What a Superbill Actually Is
A superbill is an itemized receipt for therapy, formatted with everything your insurance company needs to process an out-of-network claim: dates of service, the service code, the fee you paid, and your therapist’s license and practice information.
The process is simpler than it sounds. You pay for your session as usual, we generate a superbill for you, and you submit it to your insurer. Most now accept uploads straight through their member portal or app. Once you’ve met your out-of-network deductible, your plan reimburses a percentage of each session, often somewhere between 50% and 80% of the allowed amount depending on your specific plan.
Here’s the part clients are most surprised by: for a lot of people with decent out-of-network benefits, a $180 session ends up costing far less than that once reimbursement kicks in. The number on our fee schedule is rarely the number you actually net out at.
The Questions to Ask Your Insurance Company
One phone call to the number on the back of your card answers everything. Ask these, word for word: Does my plan include out-of-network benefits for outpatient mental health? What is my out-of-network deductible, and how much of it have I met? What percentage do you reimburse for an out-of-network psychotherapy session once the deductible is met? Do I need pre-authorization? And how do I submit claims?
Write down the answers and the representative’s name. Ten minutes on that call tells you exactly what therapy will cost you after reimbursement.
HSA, FSA, and Your Rights
Therapy with a licensed provider is generally an eligible expense for HSA and FSA accounts, so you can pay with pre-tax dollars regardless of your insurance situation.
Under the federal No Surprises Act, you’re also entitled to a Good Faith Estimate of your expected costs before treatment begins, and we provide one to every client. If you want to go deeper on your rights as an insurance consumer in this state, the Colorado Division of Insurance is the official resource.
What This Looks Like in Practice
Our session fees are published openly. Individual therapy runs $140 to $200 and couples therapy $160 to $200, with the full schedule on our FAQs page. For the bigger picture of what therapy costs in this city, see our transparent guide to Denver therapy costs.
If the insurance side still feels murky, bring your questions to a free 15-minute consultation and we’ll walk you through exactly how superbills work with your plan.
