Although Dr. Shinar is not an affiliated provider on insurance plans, most of his clients with private (PPO) insurance plans are able to obtain reimbursement for services.  In this type of scenario, you are responsible for payment upon each visit and you will be provided with an invoice to be submitted to your insurance company for reimbursement. Please call the telephone number on the back of your insurance card and ask your insurance representative what your out-of-network mental health benefits are.

To expedite the call, please provide them with the following CPT (procedure) codes:  The initial 60 minute evaluation is 90791 and the CPT code for the 45 minute follow-up sessions are 90834. Ask if you have a deductible, and if so, how much.

Many people who reach out to Dr. Shinar do so after finding out that they cannot find an in-network provider who is experienced in Cognitive Behavior Therapy.  These providers claim to have CBT training but in fact, many of these providers have merely taken a workshop or been introduced to CBT but have not had extensive training in graduate and post-graduate programs. It is typical, especially in urban areas like NYC, that people are forced to go outside of their network to obtain expert care.

If your plan does not offer "out of network" benefits, you can an request a unique alternative called a single case or ad hoc agreement in which the insurance company agrees to pay an out-of-network doctor’s fee, provided there are no experts available in network. Current laws state that if the insurance company cannot provide you with a doctor who can help you with expertise in your particular diagnosis, then they have charged you money without being able to deliver an effective service. With a single case agreement, you are requesting that they pay your out of network doctor’s fees to accommodate their lack of available experts.  Fortunately, Dr. Shinar has helped hundreds of clients through this process and they have received the treatment that they otherwise could not have afforded.

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