How to use out-of-network benefits and superbills for psychiatric care
Your PPO may reimburse part of your private pay psychiatry visits. Here’s how superbills and out-of-network benefits work, step by step.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
✓ Medically reviewed by Earl Johns, MSN, PMHNP-BC
If you have a PPO or POS plan, you may have out-of-network benefits that reimburse part of what you pay a provider outside your insurance network. A superbill is the document that makes this possible.
What is a superbill?
A superbill is a detailed receipt that includes the provider’s information, dates of service, diagnosis codes and procedure codes. You pay the provider directly, then submit the superbill to your insurance company for possible reimbursement.
How to check your out-of-network benefits
Call the member services number on your insurance card.
Ask whether you have out-of-network mental health or behavioral health benefits.
Ask about your out-of-network deductible and how much of it you’ve met.
Ask what percentage they reimburse after the deductible.
Ask how they calculate the allowed amount and how to submit a claim.
Tips for getting reimbursed
Submit superbills promptly, since many plans have filing deadlines.
Keep copies of everything you submit.
Expect reimbursement to cover part, not all, of the visit.
Use HSA or FSA funds for the portion you pay out of pocket when eligible.
Reimbursement apps can file claims for you if you’d rather not do the paperwork.
Good to know
Reimbursement is never guaranteed and depends entirely on your plan. Submitting a superbill means a diagnosis is shared with your insurer, so if privacy is a priority, you may choose to pay privately without filing a claim.
Current self-pay rates, testing costs and policies are listed on our fees and policies page. Self-pay clients receive a Good Faith Estimate when scheduling.
Care in San Francisco and across California
Wellthy Psychiatry is an LGBTQ-owned practice led by Earl Johns, MSN, PMHNP-BC, a board-certified psychiatric nurse practitioner offering medication management and therapy in San Francisco and by telehealth across California. If you’re looking for a gay or LGBTQ+ therapist in San Francisco, LGBTQ+-affirming psychiatric care in San Francisco, or affirming therapy anywhere in California, we’d love to help. Book a free 15-minute consult.
About the author
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner · UCSF-trained · Founder of Wellthy Psychiatry & Wellness
Earl provides LGBTQ+ and neurodivergent-affirming psychiatric care, blending medication management, therapy and whole-person approaches. He sees clients in San Francisco and by telehealth across California.
Keep reading
Related posts
Private pay psychiatry in San Francisco: what you get and whether it’s worth it
Thinking about paying out of pocket for psychiatric care? Here’s how private pay works, what it costs and who it’s a good fit for.
Good Faith Estimates and the No Surprises Act, explained
Your rights as a self-pay patient, what a Good Faith Estimate includes and what to do if your bill is higher.
How to compare the cost of mental health care
Questions to ask about in-network, out-of-network and self-pay options so you can choose care that fits your budget.
Does insurance cover psychiatric care? Aetna, Cigna and Optum explained
How insurance coverage works for psychiatric visits, which plans we’re in network with, and how to use out-of-network benefits.