INSURANCE POLICY FOR FAMILY THERAPY (3+ people)

While Center for Personal Wellness is an in-network provider with some insurance carriers, we will not bill insurance for family therapy for the following reasons:

 

• Family therapy is not a provided benefit under most insurance plans because plans require medical necessity for treatment. This means that to use health benefits for treatment, an individual requires a diagnosable mental health disorder while the therapist needs to prove that the disorder is causing  significant impairment in your life on a day-to-day basis. While you may have anxiety, a depressive
  disorder, or other mental health challenge, the focus of treatment in family therapy is often on improving communication and strengthening the relationships within the context of family system, rather than on your mental health condition. The insurance company does not see communication and relationship challenges as medically necessary. In family therapy the relationships ARE the client and therefore not recognized by insurance companies. They only cover the mental health of the individual who is insured.
   

• It is possible that if you call your insurance company and ask if they cover family therapy they may say “yes” but it does not guarantee coverage of services, even if you obtain an authorization number. What the insurance company is referencing in saying “yes” to family counseling is that they cover a procedure code that allows a person’s family member or significant other to be present in therapy. The
  focus of counseling is not on your relationship, but rather the treatment of a diagnosable mental health condition. They consider your partner or other family member as a support in the treatment of your mental health condition, not as a person also receiving treatment for family system challenges.
   

• Labeling one person as the “identified patient” can unbalance the treatment and run the risk of pathologizing a family member. Seeking fairness and equal responsibility for contributing to the challenges and health of the family system is our goal in family therapy.
   

• We are dedicated to providing ethical treatment and taking advantage of a medical diagnosis to justify treatment of a family system issue is misleading and not an ethical practice.