Insurance and fees

• Aetna
• Anthem / Empire BlueCross BlueShield (NY)
• The Empire Plan (NYSHIP)
• Cigna / Evernorth (Cigna Behavioral Health)
• UnitedHealthcare (UHC)
• Optum Behavioral Health / UBH
• Oscar Health (via Optum)
• AARP Medicare Advantage & Supplement (via Optum)
• Humana (incl. TRICARE East / Humana Military)
• MVP Health Care
• MagnaCare
• Excellus BlueCross BlueShield
• Medicare
• Medicaid

Coverage always depends on your specific plan, not just the company name on the card. Employer plans, marketplace plans and Medicare Advantage products from the same carrier can have different deductibles, copays and referral rules. That is why we verify each patient individually. For TMS specifically, our in-network credentialing runs through Optum Behavioral Health, and health plans generally require prior authorization before a TMS course begins. Our TMS cost and insurance page explains the criteria plans usually look for.

We are in-network with Aetna for outpatient psychiatry. Psychiatric evaluations, medication management visits and telehealth follow-ups are covered subject to your plan's deductible and copay. For TMS, we check whether your Aetna behavioral health benefit can be routed through our Optum credentialing and submit prior authorization if it can.

Cigna's mental health benefits are administered by Evernorth Behavioral Health (formerly Cigna Behavioral Health). Office and video psychiatry visits are covered as your plan allows. Some Cigna plans ask members to use an Evernorth-contracted provider for every behavioral visit, which we are, and TMS coverage is reviewed case by case with a prior authorization.

These plans share Optum Behavioral Health as their mental health manager, which is also where our TMS credentialing sits. That makes them the most straightforward route for TMS: covered when you meet the plan's medical-necessity criteria and prior authorization is approved. Psychiatry and medication management are covered under the same behavioral benefit, including AARP Medicare Advantage and supplement plans administered through Optum.

We accept Anthem Empire BlueCross BlueShield commercial plans and The Empire Plan (NYSHIP) for New York State and participating local government employees. Evaluations and follow-ups are covered according to your plan documents. Empire Plan members have their own mental health administrator, so we confirm benefits, any visit limits and TMS eligibility directly with that program.

Excellus BlueCross BlueShield is more common upstate, but some Orange County employers and families carry it. We see Excellus members at both offices for psychiatry and medication management, subject to plan terms, and will tell you before treatment whether TMS can be authorized under your policy.

MVP is widely held in the Hudson Valley, and we accept MVP Health Care plans that include our practice in their network. Psychiatry visits are covered as your plan specifies. We verify which MVP product you have, because referral and authorization rules vary between them.

We accept Humana plans, including TRICARE East through Humana Military, which serves active-duty families, retirees and reservists in our region. Behavioral health visits are covered subject to your plan; TRICARE may require a referral depending on your enrollment type, and we will check that for you.

MagnaCare is a network used by many union and self-funded employer plans in New York. If your card shows the MagnaCare logo, we are in-network for psychiatric care; the benefits themselves come from your employer's plan, so we confirm them with the plan administrator.

Original Medicare Part B covers outpatient mental health services, including psychiatric evaluations, medication management and many telehealth visits, after the Part B deductible and coinsurance. If you have a Medigap policy, it may pick up some or all of the coinsurance. Medicare Advantage members follow their plan's network and authorization rules.

We accept New York Medicaid. Most Medicaid members in the state are enrolled in a managed care plan, and the plan name on your card determines the network and authorization rules. Bring your card to the benefits check and we will confirm coverage for your visits before you are scheduled.

If your plan is not listed, you can still be seen. Many PPO and POS plans have out-of-network benefits that reimburse part of the cost; we provide a detailed receipt (a superbill) you can submit for reimbursement. Patients without insurance, or who prefer not to use it, can pay directly.

We do not post fees online because they depend on the visit type. Call us and we will quote the self-pay rate before you book. Under the federal No Surprises Act, uninsured and self-pay patients have the right to a written good-faith estimate of expected charges in advance.

1. Call (845) 480-6678 or use the contact form and share the name and member ID on your card.
2. Our front desk contacts your plan to confirm eligibility, copay or coinsurance, deductible status and any referral requirement.
3. We call you back with what to expect before your first appointment. There is no charge and no obligation.

For TMS, the check also covers prior authorization. Our team gathers the clinical documentation your plan asks for, such as previous antidepressant trials, and submits it on your behalf after your psychiatric evaluation.