SohoMD Medical Insurance Overview
Most of our providers are in-network with the following plans:
Aetna, Cigna, and Optum (Oscar, Oxford Health Plans, UnitedHealthcare)
Fees for treatment vary depending on length of appointment and type of treatment received. Payment should be made at the time of the visit. We do accept cash, all major credit cards, HSA, and FSA
Things to Know
Important information to get from your insurance carrier before booking an appointment:
• Does my plan have mental health benefits through another carrier?
• Are there any deductibles that must be met before these benefits are active, and is there any co-insurance associated with the plan?
• Are there any "out-of-network" benefits and if so, is there an “out-of-network” deductible? How much is reimbursed?
• Is a referral, or prior authorization required for treatment?
• Are there limits on the number of therapy visits in a given time period?
• How to submit claims for reimbursement (this is typically done by our office or we can give you a receipt called a "superbill" that includes all relevant diagnostic and service codes).
Codes commonly billed for appointments include:
90791 - Initial evaluation with a therapist
90792 or 99204 + 99836 - initial eval with a prescriber
99213 + 90833 – Medication check, low complexity
99214 + 90833 – Medication check, medium complexity
90834 – Psychotherapy
90837 – Psychotherapy extended time
SohoMD Policy for Appointments, Cancellations, and No-shows
You agree to the appointment times that the Soho Medical Doctors, PLLC and affiliated entities (SohoMD) staff schedules for you. Your appointment time is reserved for you and prevents other patients from using that time. As a courtesy to you, we make appointment reminder phone calls, texts, or emails one to two business days prior to your visit. It is your responsibility to remember and show up for your appointment.
If you need to reschedule or cancel your appointment, we need at least one business day to enable us to schedule someone else. (Sundays and holidays are not business days.)
You will be charged a full session rate for any missed appointment that is not cancelled at least one business day in advance. If you miss or cancel two sessions, your provider may discharge you from their service for administrative reasons.