Common Questions & Answers

Payment and Insurance

Breakthrough is an “out of network” provider for all insurance plans, meaning the practice does not participate in any insurance networks. This allows Breakthrough to provide you with the best and most effective treatments available by making the optimal treatment decisions regarding the length and type of therapy without the limitations imposed by insurance companies.

After each appointment, you will be provided a “Superbill,” which is a statement with all necessary information that insurance companies need to process out-of-network claims. Breakthrough therapists will also complete any additional paperwork required by insurance companies to help with reimbursement. Please contact your insurance company for questions about out-of-network mental health services

Questions to Ask Your Insurance Company

1. To check your out-of-network benefits, we recommend that you call your insurance company directly. Some questions include:

  • What are my mental health benefits?
  • Which CPT codes are considered eligible for out-of-network reimbursement under my plan?
  • What is my out-of-network deductible?
  • What percentage of my sessions will be reimbursed once I meet my deductible?
  • Is a referral required from my primary care physician for services to be eligible for reimbursement?

2. Common Service Codes:

  • 90791 Diagnostic Evaluation (via Telehealth or in-person)
  • 90837 60-minute individual psychotherapy (via Telehealth or in-person)
  • 90834 45-minute individual psychotherapy (via Telehealth or in-person)
  • 90832 30-minute individual psychotherapy (via Telehealth or in-person)
  • 90847 family therapy with client present (via Telehealth or in person)
  • 90846 family therapy without client present, including parent-only sessions (via Telehealth or in-person)

3. Payment:

  • Payment for each session is expected at the time of service. All major credit cards, including FSA/HSA cards, are accepted and maintained on file. Cards are charged after each session. Cancellations within 24 hours of the appointment time are charged a full session fee.

4. Client Portal:

  • Your Client Portal will be set up at your initial session. You can access your Superbill through the Client Portal. Click here to access and manage your appointments.