413 Theraworks is currently in-network with select commercial insurance plans, including:

• Blue Cross Blue Shield

• Health New England

• Aetna

Insurance participation can vary by clinician, state, and specific insurance product.

Before scheduling, our team will help determine whether one of our therapists is in-network with your plan.

When a therapist is in-network with your insurance company, they have agreed to the insurance company's contracted rate for services.

That does not necessarily mean therapy will be free.

Depending on your plan, you may still be responsible for:

• a copay

• coinsurance

• a deductible

• the full contracted rate until your deductible is met

Your exact responsibility depends on your individual insurance plan. We encourage you to confirm your cost directly with your insurance company by calling member services.

Insurance language can be confusing. Here's the simplest version:

Copay: A set amount you pay for each therapy session, such as $20 or $30.

Deductible: The amount you must pay out of pocket before your insurance begins paying for certain services.

For example, if your plan has a $2,000 deductible, you may be responsible for the insurance-contracted cost of therapy until that deductible is met.

Coinsurance: Instead of a flat copay, you pay a percentage of the cost of the session.

For example, if your coinsurance is 20%, you pay 20% of the insurance-approved rate, and your insurance pays the remaining 80%.

We can verify your insurance benefits and provide you with the information available to us before treatment begins.

However, insurance verification is not a guarantee of payment.

Your insurance company ultimately determines whether a service is covered and how much you owe.

We strongly encourage clients to also contact their insurance company directly and ask:

• Do I have outpatient behavioral health benefits?

• Do I have a deductible?

• Has my deductible been met?

• Do I have a copay or coinsurance for outpatient mental health visits?

• Are there limits on the number of therapy sessions I can receive?

• Is authorization required?

• Is my specific 413 Theraworks clinician in network?

Some insurance plans include out-of-network benefits.

If your plan includes these benefits, you may be able to receive partial reimbursement for therapy after paying for your session directly.

We can provide a superbill, which is a detailed receipt you may submit to your insurance company for possible reimbursement.

Because out-of-network benefits vary significantly, we recommend contacting your insurance company before starting treatment.

A superbill is a document that includes information such as:

• the service you received

• the date of service

• your therapist's credentials

• the diagnosis code

• the procedure code

• the amount paid

You can submit the superbill to your insurance company if your plan offers out-of-network reimbursement.

Payment to 413 Theraworks is due prior to obtaining a superbill.

You do not have to use insurance to receive therapy.

Some clients choose private pay because they:

• do not want to use a mental health diagnosis for insurance billing

• want greater privacy around treatment

• have an insurance plan we do not accept

• prefer a service that insurance does not cover

• have a high deductible and prefer to pay directly

Our current private-pay rates are:

Initial evaluation: $175

Individual therapy: $135 per 45 minute session

Couples therapy: $150 per 50 minute session

Please contact us if you have questions about the cost of a specific service.

413 Theraworks does not bill insurance for couples therapy.

Insurance generally covers treatment that is considered medically necessary for an individual diagnosed with a mental health condition. Couples therapy focuses on the relationship itself rather than treating one partner's individual diagnosis.

For that reason, couples therapy at 413 Theraworks is provided on a private-pay basis.

Having insurance does not automatically mean your insurance company pays the full cost of therapy.

You may receive a balance because:

• your deductible has not been met

• your plan requires a copay

• your plan requires coinsurance

• your insurance coverage changed

• your policy terminated

• the therapist is not in network with your specific plan

• your insurance company denied the claim

• another insurance plan should have been billed as your primary insurance

If we receive updated information from your insurance company, your account balance may change.

If you have more than one insurance plan, one plan is considered your primary insurance and the other is your secondary insurance.

The primary insurance must be billed first.

It is important to tell us about all active insurance coverage before treatment begins and to notify us immediately if your coverage changes.

Incorrect insurance information can result in claims being denied and may leave you responsible for the cost of services.

Clients are responsible for providing accurate, current insurance information.

Please notify 413 Theraworks as soon as possible if:

• you receive a new insurance card

• your employer changes

• your insurance plan changes

• you add or lose secondary insurance

• your policy terminates

• your name or identifying information changes

If an insurance claim is denied because current insurance information was not provided, you may be responsible for the balance.

413 Theraworks provides in-person psychotherapy in North Adams, Massachusetts, serving clients throughout Berkshire County and the surrounding area.

We also provide telehealth services in states where our individual clinicians are licensed.

Availability varies by therapist and state.