Out-of-Network Psychiatrist with Superbills | East Texas Psychiatry & Counseling
Out-of-network psychiatric care with superbills for insurance reimbursement — by secure telepsychiatry across Texas or in person at our Tyler clinic.
Board-certified PMHNPs. Most patients seen within a week. 90-minute first appointment. Same provider every visit. Statewide telepsychiatry from our Tyler clinic.
Why Out-of-Network Matters
If we are not in-network with your insurance plan, you can still see us as an out-of-network (OON) patient. You pay our published rate at the time of service. We provide an itemized superbill you submit to your insurance for partial reimbursement. Many PPO plans reimburse 50-70% of the session fee after you meet your OON deductible.
What You'll Pay
OON visits are paid in full at the time of service. The 90-minute initial evaluation and follow-up medication management visits each have a published rate that we share before you book. After your visit, we email an itemized superbill with CPT codes, ICD-10 diagnosis codes, and provider NPI — everything your insurance needs to process the reimbursement claim.
Cost transparency before your first visit
Our intake team confirms your expected cost in writing before you book. No surprise charges, no deposit required to schedule, no hidden add-ons. If your situation changes (insurance starts, plan changes, billing arrangement shifts), we discuss options at that point.
How It Works
After your visit, we email a superbill within 1-2 business days. You submit it to your insurance via their member portal, mail, or fax (each plan handles this differently). Your insurance processes the claim against your OON benefits and either pays you directly or applies the amount toward your OON deductible. Reimbursement timelines vary — typically 2-6 weeks.
When This Makes Sense
Your plan has OON benefits
Most PPO and POS plans cover out-of-network providers at a lower reimbursement rate. HMO and EPO plans usually do not cover OON care except in emergencies.
You've met or are close to your OON deductible
If you've already paid into your OON deductible this year (or expect to), reimbursement rates increase significantly.
You want a specific provider
If your in-network options have months-long waitlists or you specifically want care at our practice, OON gets you seen quickly with partial cost recovery.
You're using telepsychiatry coverage
Federal and Texas parity rules require most plans to cover telepsychiatry at the same OON rate as in-person visits.
Clinical Perspective
A common scenario in our practice: a patient with an Aetna PPO whose plan is technically in-network with us at the medical level but uses Optum for behavioral health — and Optum isn't accepting new patients in their area. They see us as OON, pay our rate at the time of service, and recover 60-70% via superbill reimbursement after their $750 OON deductible is met. Total annual cost is often less than driving 90 minutes to an in-network provider.
Conditions We Treat
Our psychiatric services cover the full range of adult mental health conditions. Common reasons patients come to us:
Frequently Asked Questions
How do I know if my plan has out-of-network benefits?
Check your insurance card or member portal for 'out-of-network deductible' and 'out-of-network coinsurance.' PPO and POS plans usually have OON benefits. HMO and EPO plans usually do not. Our intake team can help you check.
What's on a superbill?
A superbill is an itemized receipt with the date of service, CPT procedure codes (the visit type), ICD-10 diagnosis codes, provider NPI, our practice's tax ID, and the amount you paid. Your insurance uses these to process the reimbursement claim.
How long does OON reimbursement take?
Typically 2-6 weeks from submission. Some plans are faster, some slower. We don't control the timeline — your insurance does.
What if my insurance denies the claim?
We can help you understand the denial reason. Common reasons: not meeting your OON deductible yet, missing pre-authorization (rare for outpatient psychiatry), or the plan doesn't cover OON. Denial doesn't mean you owe more — you've already paid at the time of service.
Can I use my HSA or FSA for OON visits?
Yes. HSA and FSA cards work the same as any other payment method. The session fee is HSA- and FSA-eligible whether it's reimbursed by insurance or not.
Is OON the same as self-pay?
Functionally similar at the time of service — you pay our rate — but with OON you actively pursue partial reimbursement through your insurance via the superbill. Self-pay patients may or may not submit superbills.
Authoritative Resources
The following resources are maintained by U.S. government agencies and clinical organizations, independent of our practice:
This page provides general information about out-of-network options at East Texas Psychiatry and Counseling. Rates, network participation, and reimbursement rules can change. Confirm specifics with our intake team before your first visit.
Psychiatric care that fits your situation
Costs confirmed before booking. Most patients seen within one business week. Same provider every visit.
100 Independence Pl, Suite 307, Tyler, TX 75703
Monday–Friday, 8 AM–5 PM · Statewide telepsychiatry available
