To determine if you are eligible for reimbursement for the services offered, I recommend contacting your insurance company directly. When reaching out, please provide them with the following billing codes for reference:

Diagnosis Code: Z63.0 – Problems in Relationship with Spouse or Partner
F43.20 – Adjustment Disorder, unspecified

Treatment Codes: 90847 – Family psychotherapy, conjoint psychotherapy with the patient present
AND
99354 – Couples or Family Therapy, Extended session, 1:20 hrs – 2:04 hrs

In regards to the diagnosis code, insurance companies require a diagnosis that they deem medically necessary. The diagnosis of adjustment disorder, which refers to a situational life event, can typically be utilized in the beginning, but at some point, the insurance company may require a formal mental health diagnosis. This is not something I offer, even if either partner has one, such as depression or anxiety, as I do not feel that I am actually treating that diagnosis in couples therapy. At that point, you would either make the decision to continue to pay out of pocket, or we would discontinue treatment, as the insurance company would likely refuse continued reimbursement without a diagnosis. Let’s discuss this further if you have any questions.

The one exception to this policy is if either partner has an Autism Spectrum Diagnosis, in which case the therapy does, in fact, serve as treatment of the diagnosis. In that case I will use an applicable diagnosis code that can be used for the duration of therapy.