Relationship-Focused Counseling Services in Seattle

Clinical Interns: Our clinical interns are private pay and are not typically eligible for insurance reimbursement out of network, as most plans do not reimburse for sessions provided by unlicensed clinicians. Our interns are sliding scale, $60-$75 per session, pay what you can.

Associates: Our associate therapists are in-network with Premera, which includes Premera Blue Cross Blue Shield plans, most Lifewise, Heritage, and other Premera plans. If you have a Blue Cross Blue Shield (BCBS) insurance card, and you’re not sure if your plan is run locally through Premera, you can call the number on the back of your insurance card or log into your insurance client portal to see if we are listed as an in-network provider. You can also use our Nirvana insurance calculator on our scheduling page to see if you are out of network. 

Some BCBS plans are run locally through Regence, which we are not in-network with. This can be even more confusing because we will likely show up on BCBS lists as an in-network provider, even though we are only in-network with BCBS Premera plans–not BCBS Regence Plans. We cannot guarantee that we are in-network with your specific plan, so if insurance coverage is important to you, please confirm that your plan is indeed Premera and that your mental health benefits are run through Premera. 

As an example, Providence employees have a Premera branded insurance card. However, their mental health benefits are run through Optim rather than Premera. If you have any questions about whether or not your mental health benefits are indeed Premera, please refer to your insurance client portal, the number on the back of your insurance card, or use our out-of-network insurance calculator to see if your plan is listed as an out of network result. 

Our AASECT Certified Sex Therapist and owner, Brittany Steffen, is in-network with Lyra EAP, which will cover individual, couples, and sex therapy sessions. For more information on your Lyra benefits, contact your Lyra or HR representative. Most Lyra plans offer 25 free sessions per year to members.

The frequency and duration of therapy will vary depending on the individual or couple's needs and goals for therapy. Generally, therapy sessions are typically held once a week, although some people may choose to attend sessions more or less frequently. The duration of therapy sessions is typically between 50 minutes to an hour, however many of our providers offer 90 minute sessions upon request.

The length of time that you will be in therapy will also depend on your specific needs and goals for therapy. Some people may only need a few sessions to address a specific problem or concern, while others may benefit from longer-term therapy. The length of therapy can also vary depending on the type of therapy you are receiving. For example, cognitive-behavioral therapy (CBT) is typically shorter-term, usually, around 12-20 sessions, while psychoanalytic therapy is typically longer-term, often lasting several years.

Therapy is a process, and progress may vary for each individual. The therapist will work with you to set goals and objectives for therapy and will monitor your progress throughout the process. The therapist will also adjust the therapy plan as needed to ensure that you are making progress and achieving your goals.

It's also important to note that therapy is not a one-time solution, and most people will benefit from occasional "tune-up" sessions even after they have completed a course of therapy.

Overall, the frequency and duration of therapy will depend on your specific needs and goals for therapy and will be tailored to meet your individual needs. It's important to communicate with your therapist about your needs and goals and to work together to develop a treatment plan that best suits you.

It can be difficult to explain to a therapy client why sex therapy and couples therapy may not be covered by insurance companies. However, one reason is that insurance companies categorize these types of therapy as not “medically necessary” in the same way as other types of medical treatment. Additionally, insurance companies may have specific requirements or diagnoses that must be met before they will provide coverage for these types of therapy. To add to the confusion, Premera will tell members that couples/family therapy is a covered service code–which is correct. However, if billing accurately, the most common diagnostic code for couples therapy is “Z63.0: Problems in a Relationship with Spouse or Partner,” and insurance does not consider that diagnosis a mental health issue requiring treatment. Additionally, the CPT code for couples therapy states that one person is the client, and additional attendees are "non-clients", which does not accurately describe couples therapy, where the relationship itself is the client, and each attendee is equally considered to be a client.

Some therapists will simply choose an identified patient, assign a covered diagnosis, and bill insurance for couples therapy so that their clients can get coverage. This strategy is a great way to get coverage for couples therapy, but it leaves the provider vulnerable to an insurance audit. Our insurance contract requires us to assign the most accurate diagnosis possible, so if our notes don’t reflect that billing, Premera can claw back any payments related to the case in question. Because of that risk, we will not bill Premera for couples or sex therapy unless the primary diagnosis is accurate, billable, and not better described by a non-billable code, such as Relationship Issues. 

If you have Premera and are beginning couples or sex therapy treatment, we will have you sign an insurance waiver acknowledging that we cannot bill insurance. For non-Premera couples and sex therapy clients, we can provide superbills for out-of-network reimbursement, should your plan allow. 

For a more detailed look at this complex topic, check out our blog post on insurance and couples therapy.

Availability for phone or telehealth consultations is determined by the individual clinician. It is best to contact the clinician directly if you'd like to request a phone consultation. Some of our providers do not offer free consultations and will complete any screenings via email instead.

SCS offers sliding-scale services through our interns. Interns work on a pay-what-you-can model ranging from $60-75 per 50-minute session. Our interns train at highly qualified programs and receive frequent supervision by qualified professionals.

You do not have to provide proof of income to qualify to see clinical interns at our sliding scale rates, and can choose your price per session, within our sliding scale.

Our licensed therapists offer intake sessions at $155 per session, and are $145 per session moving forward. We can provide superbills for out of network reimbursement.

To find out what your out-of-network reimbursement for therapy will be, you will need to contact your insurance company and ask them about their out-of-network coverage. It's important to ask your insurance company the following questions:

• What is the out-of-network reimbursement rate for therapy?
• Are there any annual limits on out-of-network reimbursement for therapy?
• Are there any requirements that need to be met before I can be reimbursed for out-of-network therapy?
• Will I need to submit claims forms or any other documentation to receive reimbursement?How long will it take to receive reimbursement after I submit a claim?

To get reimbursed for out-of-network therapy, you will typically need to submit a claim form to your insurance company, along with any other required documentation. You will also need to submit proof of payment, such as a receipt from the therapist and a statement from the therapist that includes the date of service, the type of service provided, and the diagnosis.

It's important to keep in mind that the process of getting reimbursed for out-of-network therapy may take some time, and it may take several weeks or even months to receive reimbursement. It's also important to note that the reimbursement you receive may not be the full amount you paid for therapy, and you may be responsible for paying some of the costs out-of-pocket.