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Fees & Insurance
We are currently an out-of-network provider and operate on a self-pay basis. We do not bill insurance companies directly. However, we are committed to helping you maximize your benefits. We will gladly provide you with a detailed SuperBill, containing all the necessary information, which you can submit to your health insurance company for potential out-of-network reimbursement.
Our appointment fees are as follows:
- Infant Feeding Evaluations virtual and in-office = $350 in-home = $450
- Follow-up Appointments virtual and in-office = $250 in-home = $350
- Developmental Advice Sessions = $80
- NICU Care Consult = $250
- Prenatal Consult = $250
For In-Home Appointments Only:
- If you live outside of a provider's travel radius, an additional $30 for every 15-minutes of travel time will be charged.
Fees for parking and tolls will be calculated afterwards.
Maximizing Your Out-of-Network Benefits for Infant Feeding Therapy
We understand that navigating insurance for out-of-network services can feel complex, and we're committed to making the process as smooth as possible for your family. As an out-of-network provider, we do not directly bill insurance companies; however, we gladly provide you with all the necessary documentation to seek reimbursement directly from your health insurance provider.
What is a Superbill?
A superbill is a detailed receipt of services provided. It includes critical information your insurance company needs to process your claim for out-of-network benefits, such as:
Your Path to Potential Reimbursement – Step-by-Step:
Key Questions to Ask Your Insurance Provider (Important!):
When you call your insurance company, these questions can help you understand your benefits:
Typical Codes We Use on Your Superbill:
While the specific codes will always be determined by your clinician based on your infant's unique diagnosis and treatment plan, here are some common codes you might see:
CPT (Current Procedural Terminology) Codes - Treatment/Procedure Codes:
ICD-10 (International Classification of Diseases, 10th Revision) Codes - Diagnosis Codes:
Important Disclaimer:
It is the client's responsibility to understand and verify their out-of-network benefits with their insurance carrier prior to beginning services. While we provide superbills as a courtesy, we cannot guarantee reimbursement, as coverage varies greatly depending on your individual insurance plan and policy.
Need Assistance with Your Superbill?
For any questions regarding the superbill documentation we provide, please do not hesitate to contact our administrative team at info@infantfeedingspecialists.com
What is a Superbill?
A superbill is a detailed receipt of services provided. It includes critical information your insurance company needs to process your claim for out-of-network benefits, such as:
- Our provider details and tax ID
- Dates of service
- Fees for each session
- Diagnosis codes (ICD-10) specific to your infant's condition
- Treatment codes (CPT codes) for the services rendered
Your Path to Potential Reimbursement – Step-by-Step:
- Pay for Services: All services are paid for at the time of your appointment.
- Request Your Superbill: We will provide you with a comprehensive superbill after each session, or monthly, as per your request.
- Contact Your Insurance Provider: Call the "Member Services" number on the back of your insurance card. It's often helpful to have your superbill in hand during this call.
- Submit Your Claim: Follow your insurance provider's instructions for submitting an out-of-network claim. This usually involves completing a claim form (which you can often find on their website) and attaching the superbill we provide.
- There is a helpful website called Reimbursify.com that can also help with this process.
Key Questions to Ask Your Insurance Provider (Important!):
When you call your insurance company, these questions can help you understand your benefits:
- Do I have out-of-network benefits for speech therapy (CPT code 92526) for feeding/swallowing disorders (ICD-10 codes such as F98.29, R13.10, R63.3, F98.21, etc.)?
- What is my out-of-network deductible, and has it been met?
- What percentage of the service fee will be reimbursed once my deductible is met (this is often called "coinsurance")?
- Is there an annual limit on the number of sessions or the amount reimbursed for out-of-network services?
- Do I need a referral or pre-authorization from my primary care physician to receive out-of-network services?
- What is the best mailing address or online portal to submit my claim form and superbill?
Typical Codes We Use on Your Superbill:
While the specific codes will always be determined by your clinician based on your infant's unique diagnosis and treatment plan, here are some common codes you might see:
CPT (Current Procedural Terminology) Codes - Treatment/Procedure Codes:
- 92610: Evaluation of swallowing dysfunction and/or oral function for feeding
- 92526: Treatment of swallowing dysfunction and/or oral function for feeding
ICD-10 (International Classification of Diseases, 10th Revision) Codes - Diagnosis Codes:
- F98.29: Other feeding disorders of infancy and early childhood
- R63.3: Feeding difficulties, unspecified (Pediatric Feeding Disorder)
- P92.09: Other feeding problems of newborn
- R13.10: Dysphagia, unspecified (difficulty swallowing)
Important Disclaimer:
It is the client's responsibility to understand and verify their out-of-network benefits with their insurance carrier prior to beginning services. While we provide superbills as a courtesy, we cannot guarantee reimbursement, as coverage varies greatly depending on your individual insurance plan and policy.
Need Assistance with Your Superbill?
For any questions regarding the superbill documentation we provide, please do not hesitate to contact our administrative team at info@infantfeedingspecialists.com