Angel Carswell Angel Carswell

I’m Making a Change… Goodbye Insurance!

Care without codes, labels, or limits.

After months of reflection and deliberation, I wanted to share an important update about my practice. Beginning February 2026, I will fully transition from accepting insurance & insurance EAP to private pay only for all sessions. 

How this change benefits you!

Enhanced privacy and confidentiality: When using insurance, diagnostic labels, treatment plans, and clinical notes often become part of your permanent record within insurance systems. With self-pay, your therapeutic information stays solely between us, giving you much more control over your privacy.

More flexibility in your treatment: Insurance companies often influence how often we can meet, how long sessions can be, and which types of treatment are considered medically necessary. Shifting to self-pay allows us to tailor therapy to your needs, not what a third party approves.

Reduced stigma and no pressure for unnecessary diagnoses: Insurance requires a mental health diagnosis to approve and pay for therapy. This can create the message that every struggle must be labeled as a mental illness, and not every challenge requires a diagnosis. Many things you face are normal human experiences rather than clinical disorders.

More continuity and stability in care: Plan changes, deductible resets, or insurance network shifts can interrupt care. With self-pay, you keep the clinician who already knows you well and understands your long-term goals.

Out-of-network benefits may help cover part of your cost: If your insurance plan offers out-of-network benefits, you may be able to get partial reimbursement for your sessions even though I am not billing insurance directly. Many plans will reimburse a percentage of the session fee once you meet your out-of-network deductible.

If this applies to you, I can provide a monthly statement (also called a superbill) that you can submit to your insurance for possible reimbursement. This allows you to use your benefits while still having the privacy and flexibility of self-pay.

Why I am making this shift!

I have always built my practice around what is best for the client. Over time, I have come to realize that the constraints insurance places on the therapeutic process, including diagnostic requirements, session limitations, and documentation demands, are no longer in line with the kind of supportive, individualized practice I want to run. Moving to a self-pay model allows me to provide care that is more aligned with my values and gives us the freedom to work together in a way that genuinely supports your wellbeing.

What You Need to Do

You can view the session lengths & rates offered on the Services page.

If you plan to use out-of-network benefits, call your insurance company to ask:

  • Do I have out-of-network mental health benefits?

  • What percentage do you reimburse for CPT code 90837 or 90791?

  • What is my out-of-network deductible, and how much of it has been met?

  • How do I submit claims or superbills?

Thank you for your continued trust and for being such an important part of my practice.

Read More