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Old Feb 03, 2018, 10:10 AM
Elio Elio is offline
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Member Since: Sep 2006
Location: in my head
Posts: 2,913
Ok, how does one get therapy visits treated like medical visits? Is it based on diagnosis, billing codes?

So far I've been seeing my T for 2 x wk for over a year now with no problems and yeah, I'd say that they are treated like medical visits in the sense that I pay the co-pay until out of pocket max for the year has been reached and then insurance covers 100%. I expect that I have reached out of pocket max for the year already because of my 3 day hospitalization and surgery. So, really if they are going to cover it, now would be the time to up my sessions. I guess I'm concerned at that concept of "medical necessity". I am far from the crisis place where I was suicidal and I don't need more visits to keep me away from there in general. I could probably even get away with weekly visits from that stand point. However, I would make little to no progress on my social isolation issues and uncertain on my food issues as I still am not able to manage those over the long term. Would that constitute medical necessity though? And does my food issues even meet the criteria for an official eating disorder. I think they do but doesn't match exactly.

Do you know if your T has had to submit treatment plans, official dx, and progress reports? If yes, have you preferred to know what was in those reports or prefer not to know? Does it matter to you?