Therapists decide which insurance companies they want to accept; they can choose to accept some insurances but not others, only a few, or none at all. Contracting with an insurance company means they agree to accept a standard fee per session. To receive payment, therapists need to report each session to the insurance company and provide an accepted reason for the session (or “diagnostic code”), and then wait for payment.
Therapists might decide not to contract with insurance companies because payments are frequently delayed, meaning they won’t get paid until months (even years) after the session occurs. Payments from an insurance company are typically lower than what they might otherwise accept out-of-pocket. Therapists are also limited to what insurance companies decide is a good reason for therapy to happen, how long the session should last, and how frequently they can occur.
By not contracting with insurance companies, therapists are able to spend more time with clients than on billing, and use their clinical judgement to determine what is best for a client, instead of an insurance company dictating limits.