Luminous Vitality Behavioral Health is a private-pay, out-of-network psychiatry practice in Massachusetts. You pay at the time of your visit and receive a superbill — an itemized receipt with the codes your insurer needs. If your plan has out-of-network benefits (many PPO and POS plans do), you submit the superbill and your plan may reimburse a portion of the cost.
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What does “out-of-network” mean for psychiatry?
Out-of-network means the practice does not bill your insurance company directly and is not contracted with any insurer. You pay the practice directly, and — if your plan includes out-of-network benefits — your insurer may reimburse you for a portion after the visit. Many patients choose out-of-network psychiatry because it means longer appointments, continuity with the same physician, no formulary restrictions on which medication can be prescribed, and no insurer sitting between you and your care.
What is a superbill?
A superbill is an itemized receipt for a medical visit. It contains everything your insurer needs to process an out-of-network claim: the date of service, the practice’s name and NPI, your diagnosis code(s), the CPT procedure code(s) for the visit, and the amount you paid. LVBH provides a superbill on request. You submit it to your insurance company (usually through your plan’s member portal, by app, or by mail), and the plan applies your out-of-network benefits.
Which plans reimburse out-of-network psychiatry — and which don’t?
This is the single most important thing to check before your first visit, because plan types differ sharply. In general: PPO and POS plans commonly reimburse part of out-of-network care after your out-of-network deductible; EPO and HMO plans usually do not cover out-of-network — verify with your plan. Reimbursement varies and is not guaranteed.
- PPO (Preferred Provider Organization): Usually include out-of-network benefits. These plans commonly reimburse part of out-of-network care after you meet your out-of-network deductible.
- POS (Point of Service): Often include out-of-network benefits, sometimes requiring a referral. Similar to PPO for reimbursement.
- EPO (Exclusive Provider Organization): Generally do not cover out-of-network care except in emergencies.
- HMO (Health Maintenance Organization): Generally do not cover out-of-network care except in emergencies.
- High-deductible / HSA-eligible plans: You can typically pay with HSA/FSA funds; reimbursement still depends on whether the plan has out-of-network benefits.
Reimbursement varies by plan and is not guaranteed. The only way to know your specific benefit is to call the member-services number on your insurance card and ask the questions below.
Exactly what to ask your insurance plan
Call the member-services number on the back of your card and ask:
- “Does my plan include out-of-network outpatient mental health / psychiatry benefits?”
- “What is my out-of-network deductible, and how much of it have I met this year?”
- “After the deductible, how much of the allowed amount do you reimburse for out-of-network outpatient psychiatry (for example, CPT 90792 for a psychiatric evaluation, and 99214 or 99213 with add-on 90833 for follow-ups)?”
- “What is the allowed amount (the ‘reasonable and customary’ rate) you use for those codes?”
- “How do I submit a superbill for reimbursement, and is there a filing deadline?”
- “Is a referral or prior authorization required for out-of-network mental health?”
Write down the reference number for the call.
How reimbursement is actually calculated
When a plan does reimburse out-of-network care, it typically pays a share of its own “allowed amount” for each code — not necessarily the amount you paid. Two things drive what you get back: the plan’s allowed amount for the visit codes, and how much of your out-of-network deductible you have already met. Because those two figures, not any single headline number, determine your reimbursement, the member-services questions above matter far more than any estimate. Reimbursement varies by plan and is not guaranteed.
The Massachusetts angle: why out-of-network is common here
Massachusetts has a well-documented shortage of psychiatrists, and many clinicians have moved to private-pay / out-of-network models to protect appointment length and clinical independence. If your plan’s in-network directory has long waits or few prescribers taking new patients, your plan may have a network-adequacy or continuity-of-care process worth asking about. It does not guarantee anything, but it is a legitimate question to raise with member services when in-network access is genuinely limited.
How it works at LVBH
- Book a free 15-minute consult to confirm fit.
- Complete your initial evaluation by secure video ($400).
- Pay at the time of service; receive your superbill.
- Submit the superbill to your plan and receive any out-of-network reimbursement directly from your insurer.
See full pricing on our Fees & Insurance page. LVBH provides psychiatric care for adults 18 and older across Massachusetts, including anxiety, depression, and adult ADHD. Learn more about how telepsychiatry with us works, read about our approach as a psychopharmacologist in Boston, or see why patients choose us as a psychiatrist serving the Boston area.
Medically reviewed by Dr. Ronald Lee, MD — board-certified psychiatrist, Harvard-trained in residency. Last reviewed: July 5, 2026.
If you are in crisis or thinking about harming yourself, this page is not for emergencies — call or text 988, or call 911. See our Massachusetts mental health crisis resources.
Frequently asked questions
Does insurance ever pay for an out-of-network psychiatrist?
Sometimes, if your plan has out-of-network benefits. PPO and POS plans commonly reimburse part of out-of-network care after your out-of-network deductible; EPO and HMO plans usually do not cover out-of-network — verify with your plan. Reimbursement varies and is not guaranteed. You pay the practice, submit a superbill, and — where benefits apply — your plan reimburses you a portion of its allowed amount after your out-of-network deductible.
What is a superbill and how do I use it?
A superbill is an itemized medical receipt with the diagnosis and procedure codes, the practice’s NPI, and the amount you paid. You submit it to your insurer through their member portal, app, or by mail to request out-of-network reimbursement. LVBH provides a superbill on request.
How much will I get reimbursed for out-of-network psychiatry in Massachusetts?
It depends on your plan’s out-of-network benefits, its allowed amount for the visit codes, and how much of your out-of-network deductible you have met. Reimbursement varies by plan and is not guaranteed. Call your plan’s member services to confirm your specific benefit before your first visit.
Can I use my HSA or FSA to pay?
Typically yes — psychiatric care is an eligible medical expense, so HSA/FSA funds can usually be used to pay LVBH directly. Whether you also receive insurance reimbursement still depends on your plan’s out-of-network benefits.
Do you accept insurance directly?
No. LVBH is private pay / out-of-network and does not bill insurers directly or participate in any insurance network. We provide a superbill so you can seek reimbursement through your own plan’s out-of-network benefits.
How much does a visit cost?
$400 for the initial evaluation (60 minutes) and $250 for each follow-up (25 minutes). See the Fees & Insurance page for full details.