Good news—Inner Balance Counseling is expanding your care options

Dear Inner Balance Counseling Clients, 

We have exciting news: Inner Balance Counseling is now recognized by Blue Cross Blue Shield Plans as a facility. This lets us expand services, add new programs, and strengthen the care we provide—while you continue with your current therapist and treatment plan. We expect to add other insurers over the coming months.

What’s changing with insurance?
Your plan may now process your therapy sessions under a different benefits category—often called facility-based outpatient or outpatient hospital/clinic benefits. That category can have different cost-sharing (copays, deductible, or coinsurance) than standard office visits. Coverage varies by plan.

What you can do next (recommended):
Call the number on your insurance card and verify your facility-based outpatient mental health benefits. If you are continuing weekly therapy, ask about CPT 90837 (55-minute psychotherapy; many plans list it as 53+ minutes). If you are a new client, also ask about CPT 90791 (intake/diagnostic evaluation). We’ve included a simple script below to help.

We’re excited about what this enables—more options, more programs, and more support for your healing. Thank you for being part of our community and trusting us with your care.

‍

Client Insurance Call Script

“Hi, I’m a client at Inner Balance Counseling. I need to verify my outpatient facility-based mental health benefits (sometimes listed as outpatient hospital/clinic).”

For ongoing therapy (current clients):
“Are 55+ minute psychotherapy sessions covered under CPT 90837 when billed by a facility? Based on my deductible and coinsurance today, what is the estimated dollar amount I will owe for my next 90837 session at Inner Balance Counseling? If you can’t give an exact figure, please tell me the allowed/contracted amount for 90837 and my copay/coinsurance so I can calculate it.”

For new clients (first appointment ONLY):
“Are intake/diagnostic evaluations covered under CPT 90791 when billed by a facility? What is the estimated dollar amount I will owe for my 90791 intake? After that, what is the estimated dollar amount I will owe for my 90837 ongoing sessions? If an exact figure isn’t available, please provide the allowed amounts and my copay/coinsurance.”

Follow-up questions to confirm:

• Is cost-sharing different under the facility/outpatient category versus standard office/professional visits?
  
  
• What is my deductible status and coinsurance for facility-based outpatient mental health?
  
  
• Do I have a separate out-of-pocket maximum for facility services?
  
  
• Is preauthorization required for 90791 or 90837 under the facility/outpatient category?
  
  

 “If your insurance is unable to locate Inner Balance Counseling in Mesa/Tempe, have them look us up by our  facility NPI (1720693062).