Health Care Service Corporation (HCSC) Mental Health Coverage Guide
Health Care Service Corporation (HCSC) is the largest customer-owned health insurer in the U.S., operating Blue Cross Blue Shield plans in Illinois, Texas, Montana, New Mexico, and Oklahoma. Combined, HCSC covers approximately 17 million members.
How to Verify Your Mental Health Benefits
Before your first appointment, verify your specific benefits so you know what to expect. Here is a step-by-step process for Health Care Service Corporation (HCSC) members:
- Call 1-800-851-2227 and have your member ID card ready.
- Ask to speak with the behavioral health benefits department.
- Ask: "What is my deductible for outpatient mental health services, and how much have I met?"
- Ask: "What is my copay or coinsurance for an in-network therapy session?"
- Ask: "Do I have out-of-network benefits, and what is the reimbursement rate?"
- Ask: "Is prior authorization required for outpatient therapy?"
- Ask: "Is there a session limit per year?"
- Ask: "Are telehealth sessions covered at the same rate as in-person?"
Know Your Rights: Mental Health Parity Act
Federal law requires Health Care Service Corporation (HCSC) to cover mental health services at the same level as medical and surgical benefits. If you are denied coverage, ask for the denial in writing and reference the Mental Health Parity and Addiction Equity Act.
Want to keep track of all these details? Use our free benefits verification worksheet to organize your coverage information.
Finding an In-Network Therapist
Search Health Care Service Corporation (HCSC)'s provider directory directly: Find a therapist in your area
Tips for Using the Health Care Service Corporation (HCSC) Directory
- Filter by "Behavioral Health" or "Mental Health" specialty.
- Check that the provider is accepting new patients before calling.
- Confirm the provider is in-network for your specific plan (not just Health Care Service Corporation (HCSC) generally).
- Look for providers who specialize in your specific concern (anxiety, depression, trauma, etc.).
Types of Providers Covered
Telehealth Coverage
Health Care Service Corporation (HCSC) covers telehealth therapy sessions, so you can meet with a therapist from home via video or phone.
Couples & Family Therapy
Family/couples therapy covered with a diagnosed condition under CPT 90847.
Understanding Your Health Care Service Corporation (HCSC) Coverage
Available Plan Types
Behavioral Health Managed By
HCSC Behavioral Health
Some Health Care Service Corporation (HCSC) plans outsource behavioral health management. You may need to call the behavioral health manager directly for authorizations and provider searches.
Prior Authorization
Generally not required for outpatient therapy. Required for residential treatment and intensive programs.
Substance Use Treatment
Health Care Service Corporation (HCSC) covers substance use disorder treatment, including outpatient counseling, intensive outpatient programs, and inpatient rehabilitation.
Common CPT Codes for Therapy
These are the billing codes your therapist will use when filing claims with Health Care Service Corporation (HCSC):
| CPT Code | Description |
|---|---|
| 90791 | Psychiatric diagnostic evaluation |
| 90834 | Individual therapy (45 minutes) |
| 90837 | Individual therapy (60 minutes) |
| 90847 | Family / couples therapy (with patient present) |
| 90846 | Family therapy (without patient present) |
| 90853 | Group therapy |
How to Get Reimbursed (Out-of-Network)
If you are seeing a therapist who is not in Health Care Service Corporation (HCSC)'s network, you may still be able to get reimbursed. Here is how:
- Pay your therapist directly at the time of your session.
- Request a superbill from your therapist after each session. This is a detailed receipt with the information Health Care Service Corporation (HCSC) needs to process your claim.
- Submit your claim to Health Care Service Corporation (HCSC) using one of these methods:
- Online: Submit through the member portal
- Mobile App: Submit via the Health Care Service Corporation (HCSC) app
- Fax: 1-800-832-4075
- Mail: BCBS of Illinois, P.O. Box 805107, Chicago, IL 60680-4112
- Wait for processing. Most claims are processed within 30 days. You will receive an Explanation of Benefits (EOB) showing what was covered.
Health Care Service Corporation (HCSC) Claims Note
Claims address varies by state. Use the BCBS website for your specific state (bcbsil.com, bcbstx.com, bcbsmt.com, bcbsnm.com, bcbsok.com).
What Your Superbill Should Include
- Therapist's name, credentials, NPI number, and tax ID
- Date of service
- CPT code (e.g., 90834 or 90837)
- ICD-10 diagnosis code
- Amount charged
- Your name and date of birth
Health Care Service Corporation (HCSC) tip: Use the claims address for your specific HCSC state plan as listed on your member ID card. Include the three-letter prefix from your member ID.
Save Money on Therapy with Health Care Service Corporation (HCSC)
Use Your HSA or FSA
Therapy is an eligible expense for Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs). You can use these pre-tax dollars to pay for copays, coinsurance, and out-of-network therapy costs, effectively saving 20-35% on your therapy expenses.
Ask About Sliding Scale Fees
Many therapists offer reduced rates based on your income. If you have a high deductible Health Care Service Corporation (HCSC)plan or high out-of-pocket costs, ask your therapist about sliding scale options. Some therapists will also offer "single-case agreements" with Health Care Service Corporation (HCSC) at a negotiated rate.