Cost, Coverage & Payment
Insurance, Superbills & HSA/FSA
Brinkley Psychology is a private-pay practice in Richmond, VA. That's a deliberate choice about the kind of care we provide, and it doesn't mean insurance can't help with the cost. This page explains how superbills can get you money back from your plan, how to pay with HSA or FSA funds, and why we work this way.
How paying for care works here.
You pay us directly at the time of service. Clinical services are $150 per hour, and your initial consultation is free. At that consultation we walk through what your situation calls for and give you a clear estimate of the total cost before you commit to anything.
After each service, we provide a superbill, an itemized medical receipt your insurance company understands. If your plan includes out-of-network benefits, submitting it can get part of the cost reimbursed. HSA and FSA funds can also pay for evaluations and therapy. The rest of this page covers each piece in detail.
Why we stay out of network
When a practice joins an insurance network, the insurance company gets a say in the care. It decides how many testing hours it will pay for, which measures count, and whether the result fits its coverage rules. For some kinds of care that trade-off is manageable. For the evaluations we do, it works against families.
Our assessments are comprehensive by design. Dr. Brinkley spends hours getting to know each client: parent interviews, observation in different settings, rating scales from the people who see your child every day, and a full battery of testing chosen because it helps answer your question. Insurance companies reimburse the bare minimum needed to attach a diagnosis code. Hours beyond that minimum get denied, and when a diagnosis doesn't fit the exact parameters the company requires, the claim can be denied outright, after the work is already done. Practices that live on insurance payments end up shaping their evaluations around what a claims reviewer will approve. We shape ours around your child.
Staying out of network also keeps our waitlist short. In-network testing practices carry the heavy caseloads the insurance model demands, and families in the Richmond area routinely wait months for an appointment. We see families sooner and give each one more time, including a two-hour feedback session where we walk through every result together.
There's a quieter benefit too. When insurance pays for an evaluation, the diagnosis becomes part of your insurance record. When you pay privately, you own the report and decide who sees it.
How superbills and out-of-network reimbursement work
You pay at the time of service
By card, including HSA and FSA cards. Your receipt comes through the patient portal.
We give you a superbill
An itemized receipt listing each service with the billing codes insurers use, the fees you paid, our practice details, and the diagnosis code when one applies. Nothing for you to fill out.
You submit it to your insurer
Most insurance companies accept superbills through their member portal or app. It takes a few minutes.
Your insurer pays you back
If your plan has out-of-network benefits, reimbursement goes directly to you, since you already paid us. The amount depends on your plan's deductible and reimbursement rate.
We help if you get stuck
If your insurer needs additional documentation, contact our office and we'll provide what we can.
Five questions to ask your insurance company
Call the member services number on the back of your insurance card and ask these questions. Write down the answers and the name of the person you spoke with.
- Do I have out-of-network benefits for mental or behavioral health?
- What is my out-of-network deductible, and how much of it have I met this year?
- What percentage of the allowed amount do you reimburse for psychological testing (billing codes 96130, 96131, 96136, and 96137) and diagnostic interviews (code 90791)?
- Do I need pre-authorization for psychological testing to be reimbursed?
- How do I submit a superbill, and how long does reimbursement take?
One honest caution: reimbursement varies widely. Some plans return a meaningful share of the cost, and some plans have no out-of-network benefits at all. Making this call before your first appointment means no surprises later.
Using HSA and FSA funds
Yes, you can use them here. Psychological evaluations and therapy for a diagnosed or suspected condition are qualified medical expenses under IRS rules (Publication 502), which makes them payable with Health Savings Account and Flexible Spending Account funds. Use your HSA or FSA card at the time of service the same way you'd use any debit card.
A few practical things to know. Keep your superbill and receipts, since plan administrators can ask for documentation, and a few FSA administrators want a letter of medical necessity, which we can provide. FSA money expires at the end of your plan year, and the full amount you elected is available on day one, so unspent FSA funds late in the year are a smart way to pay for an evaluation you've been putting off. HSA funds never expire.
Two caveats. If your insurance company later reimburses part of a cost you paid with HSA or FSA dollars, you can't count the same dollars twice, so ask your plan administrator how to handle it. And testing done purely for private school admissions, with no clinical question attached, doesn't always qualify as a medical expense. For tax questions, your plan administrator or accountant is the right resource.
Clinical services are $150 per hour, and your initial consultation is free. The total depends on the service, so at your consultation we map out exactly what your evaluation involves and what it will cost. Every client also receives a written Good Faith Estimate before care begins, as required by the federal No Surprises Act.
Frequently asked questions
Do you take insurance?
No. Brinkley Psychology is out-of-network with all insurance companies, including Anthem, Aetna, Cigna, Sentara, and UnitedHealthcare. You pay us directly, and we provide a superbill you can submit to your plan for out-of-network reimbursement if your plan offers it.
How much will my insurance company reimburse me?
It depends entirely on your plan. Plans with out-of-network mental health benefits reimburse a percentage of what they consider the allowed amount for each service, after you meet your out-of-network deductible. The only way to get a real number is to call the member services line on your insurance card and ask the five questions listed above.
Can I pay with HSA or FSA funds?
Yes. Psychological evaluations and therapy for a diagnosed or suspected condition are qualified medical expenses under IRS rules, so HSA and FSA funds can pay for them. Keep your superbill as documentation for your plan administrator.
Why doesn't Brinkley Psychology take insurance?
Insurance companies reimburse the minimum needed to attach a diagnosis code, and they deny claims that fall outside their parameters. Our evaluations are built the opposite way: more time with each client, observation across settings, and every test that helps answer your question. Staying out of network also keeps our waitlist short and protects your privacy, since no claims reviewer decides what care you receive.
What do services cost at Brinkley Psychology?
Clinical services are $150 per hour, and your initial consultation is free. The total depends on which service fits your situation, so at the free consultation we walk through what your evaluation involves and give you a clear estimate before you commit to anything. Call 804-205-7624 to get started.
Not sure where to begin?
Reach out for a brief, free consultation. We’ll talk through what’s going on, what it will cost, and figure out the right next step together.