In-network with Providence for outpatient therapy.
In-network for Providence Health Plan. Direct billing, copay or coinsurance at the session. Providence is tied to Oregon's major Providence hospital system and is one of the PEBB medical carriers.
Request a free 15-min consultation →Direct billing, no paperwork on your end.
In-network billing means I send the claim to your insurer directly. You pay your copay or coinsurance at the session, and the rest is handled between me and them.
Providence Health Plan is the insurance arm of the Providence Health & Services hospital system. The two are connected but the health plan is a distinct business, and you can have Providence insurance without being a patient at Providence hospitals. Their behavioral health network is administered in-house. On PEBB, the two Providence options are Providence Choice (the coordinated-care plan, with a primary-care anchor and a narrower in-network expectation) and Providence Statewide (the open-access PPO with the wider network). I'm in-network for the standard Providence commercial plans and for both PEBB Providence tiers. The Medicare Advantage side (Providence Health Assurance) is a separate provider contract that I don't currently hold, so Providence MA clients would be self-pay with me or would need a Medicare-contracted provider. I bill Providence directly for the commercial and PEBB plans. One Providence-specific note: some self-funded employers use Collective Health as their TPA and layer Providence's provider network on top, so your card or EOBs may route through the Collective Health name. The billing path still ends with me in-network on the back end.
If your specific Providence plan turns out to be out-of-network with me, you have two options: pay the self-pay fee directly ($250 per fifty-minute session), or pay the self-pay fee and submit a superbill to Providence for out-of-network reimbursement. Most out-of-network benefits cover a portion. Some cover most of it.
What you should actually expect.
What's specifically worth knowing about Providence coverage before the first session.
Providence outpatient mental health is typically billed at parity with medical visits. Copays are commonly in the $25-40 range or coinsurance 10-20% after deductible. Some employer groups waive the mental health deductible; PEBB Providence Choice has its own deductible structure worth checking against your specific year's benefit. Telehealth has been parity-billed since 2020. For couples sessions, Providence has paid out on standard outpatient psychotherapy codes with a clinical diagnosis attached. The Collective Health routing on some employer plans doesn't change what I see on the back end.
For the full carrier list and the out-of-network superbill explanation, the insurance overview covers the broader practice context.
What to ask member services.
The cleanest verification before our first session is a five-minute call to Providence member services. Here's the script that gets useful answers.
Call the member services number on the back of your card and ask these three questions:
- Is provider Gerry McNamara, LMFT (NPI available on request) in-network for outpatient mental health on my plan?
- What's my copay or coinsurance per session for CPT code 90834 (individual psychotherapy)? And for CPT 90847 if we're doing couples or family sessions?
- Has my deductible been met for the year? If not, how much is left, and does my plan have a separate behavioral-health deductible?
If anything they tell you doesn't line up with what I'm saying on the consult, that's a useful signal: we sort it out before the first session rather than after a surprise EOB.
Questions I get asked about Providence.
I'm on Providence PEBB. Are you in-network?
Yes for both PEBB Providence tiers (Choice is the coordinated-care plan, Statewide is the open PPO). I bill Providence directly. You pay your copay or coinsurance, and the EOB shows up in your member portal once the claim clears.My card says Collective Health, not Providence. Is that a problem?
No. Some self-funded employers use Collective Health as the TPA and layer Providence's provider network on top, so your card and EOBs route through the Collective Health name. The billing path still routes me as in-network on the back end. The verification on the consult would just confirm your specific plan's setup.Is Providence Health Plan different from Providence the hospital?
They're connected but distinct. Providence Health & Services is the hospital system; Providence Health Plan is the insurance company they own. You can have Providence insurance without ever being a Providence hospital patient, and you can be a Providence hospital patient with a different insurance carrier. The plan is what matters for our billing.Does Providence cover couples therapy?
In my experience, yes, billed under standard outpatient psychotherapy codes with a clinical diagnosis for one partner. Providence has been consistent. If you want certainty up front, your member services line can verify the specific plan benefit.
What I help with that Providence covers.
Anxiety therapy
Practical, multi-modal anxiety therapy. Covered by Providence the same way any standard outpatient mental health visit is.
Read moreDepression therapy
Depression therapy for adults who are tired of being tired and want to understand what's underneath.
Read moreCouples therapy
Gottman-trained couples therapy. Insurance coverage for couples depends on plan specifics, which we'd verify on the consult.
Read more
Ready to talk it through? Let's see if we're a fit.
Send a message, or set up a free 15-minute phone consult. You can reach me by email, call, or text. I'll get back to you within two business days.