Wellness Psychiatry- FAQs

Are Wellness Psychiatry Physicians licensed in my state?

Wellness Psychiatry physicians are licensed to provide services in New York, Florida, Massachusetts, Wisconsin, and South Carolina. They are also licensed to practice in California outside Wellness Psychiatry’s corporate structure. Our commitment is to meet you where you are, ensuring accessible care nationwide. Confirm your eligibility when you contact us. We do provide in-person services in NYC and nearby areas.

Are Wellness Psychiatry services covered under insurance?

Wellness Psychiatry operates on a private pay, out-of-network basis and does not accept insurance. This approach allows us to provide highly personalized, accessible, and comprehensive care without the limitations imposed by insurance. As a result, we can dedicate more time to you, create tailored treatment plans, and offer greater flexibility in services.

While we do not bill insurance directly, we provide a detailed superbill that you can submit to your insurance company for potential reimbursement. This way, you can utilize your out-of-network benefits while receiving the exceptional care you deserve. Feel free to contact us with any questions about this process!

Choosing an out-of-network psychiatrist offers several advantages:

Privacy: Insurance companies typically require detailed documentation to process claims, including session notes and psychiatric diagnostic codes. By opting for an out-of-network provider, you avoid having to share this sensitive information, ensuring enhanced privacy for your mental health care.

Flexibility: Your treatment is not restricted to services deemed billable by insurance, allowing for longer or more frequent sessions and a broader range of treatment options.

How can I learn more about your fees?

We aim to ensure that you fully understand our pricing structure so you can make informed decisions about your care. Transparency and personalized support are key to our approach. Our fee is listed on the fees page. Suppose you have more questions or are wondering about the duration of the initial appointment. We can answer those during your initial consultation or inquiry. If you have specific questions or need clarification, feel free to reach out via email or phone. We’re happy to provide personalized guidance and discuss your options.

Can I Use My Out-of-Network Benefits to See You?

If you have a PPO insurance plan, you may be able to use your out-of-network benefits for partial reimbursement. After meeting your out-of-network deductible, your insurer may cover a percentage (typically 40–80%) of the “maximum allowable amount,” determined by your insurance provider. It may be lower than the full cost of services. HMO and EPO plans typically do not include out-of-network benefits.

Do You Provide Superbills for Insurance Reimbursement?

Yes, we provide superbills for patients seeking reimbursement through their out-of-network insurance benefits. A superbill is an itemized receipt that includes all the necessary information your insurance company requires to process a claim, such as diagnosis codes, procedure codes, and payment details.

How Do I Use a Superbill to Get Reimbursed?

After receiving your superbill, you can submit it to your insurance company directly. Many insurers allow submissions online through their member portal, by mail, or via a dedicated claims department. Reimbursement is typically based on your insurance policy’s out-of-network benefits, and you may need to meet a deductible before coverage begins.

How Can I Contact My Insurance for Potential Reimbursement?

If you’re interested in seeking reimbursement for our out-of-network services, here’s a step-by-step guide to help you navigate the process:

Gather Key Information:
- Have the following details ready before contacting your insurance provider:
  - Our services are out-of-network.
  - CPT codes for the services you’ll be receiving (see list below).
  - Our practice NPI number is 1881422129, and you may be asked about the name of the physician you will be seeing: Roopma Wadhwa, MD, or Vikas Gupta, MD
Call Your Insurance Provider:
- Use the customer service number on the back of your insurance card. Ask to speak with someone about your out-of-network mental health benefits.
Ask the Right Questions:
When speaking with your insurance provider, consider asking the following:
- Do I have out-of-network benefits for mental health and/or substance use services?
- Do I need to have a prior authorization to have services covered? If so, how do I go about getting a prior authorization?
- Are there any deductibles, out-of-pocket, co-insurance, and/or other amounts that I am responsible for before benefits kick in? How much are these amounts?
- How much of my deductible has been met?
- What percentage of the fees will be reimbursed after I meet my deductible?
- Where and how do I submit bills/claims to get reimbursed?
- Do I need a special form to submit bills/claims
- Are the following CPT codes covered for reimbursement under my plan:
  - 90792 – Initial psychiatric assessment, also known as Psychiatric diagnostic evaluation with medical services
  - 99213 / 99214 – Medication management (30 minutes)
  - 99214 + 90833 – Medication management with therapy (30 minutes)
  - 99213 + 90836 – Medication management with therapy (45 minutes)
  - 99215 + 90836 – Medication management with therapy (60 minutes)
  - 90791 – Initial therapy assessment
  - 90832 / 90834 / 90837 – Individual therapy follow-ups (varied durations)
- Before you end the conversation, write down the date, name, and contact number of the agent you spoke with.
- Regarding CPT codes for wellness services and obesity management, please get in touch with us and we can provide a list of typical visit types and CPT codes.
Submit a Superbill:
- After each session, we’ll provide you with a detailed superbill. This includes all the information your insurance company requires, such as CPT codes, diagnosis codes, and payment details.
Submit the Claim:
- Most insurance companies allow you to submit claims online through their member portal, mail, or fax. Follow their instructions to ensure a smooth submission process.
Follow Up:
- If you don’t hear back within a reasonable timeframe, contact your insurance provider to check on the status of your claim.

Note: Reimbursement depends on your specific plan, and we cannot guarantee coverage. We recommend verifying your benefits before starting treatment to avoid surprises.

By following these steps, you can better understand your insurance benefits and explore reimbursement options for your care. For additional assistance, feel free to contact us—we’re here to help!

How Can I Schedule an Appointment?

Scheduling an appointment is simple—you can reach out to us directly through the website or by phone or directly schedule a complimentary consultation by clicking the schedule page. After the complimentary consultation, if you would like to work together, you will receive an invitation to the secure patient portal where you will receive forms to complete before your initial visit.

Do you offer same-day appointments?

We do not offer same-day appointments. If you are experiencing an emergency, please call 911 or visit the nearest emergency room immediately. Our intake process begins with scheduling an initial phone consultation for non-emergency situations. Before proceeding with your first appointment, this step helps determine if the doctor fits your current needs.

How soon can I be seen?

At this time, the appointments can be scheduled relatively soon. Contact us if you require an appointment soon, and we can facilitate that request.

Are you offering in-person visits?

Currently, all appointments are conducted via secure telehealth using Zoom. This includes telepsychiatry sessions for convenient, confidential, and accessible care. However, in-person visits will soon be available in Manhattan. If you are only interested in an in-person visit, please schedule a complimentary consultation, and we can discuss if that can be arranged.

Do you offer virtual appointments?

We use Zoom for Healthcare, a HIPAA-compliant platform, to ensure your privacy during video sessions. Patients must have working audio and video, as telephone sessions are unavailable. For safety, appointments cannot be conducted in a moving vehicle. Please ensure you are in a private space for your session.

What is your appointment change and cancellation policy?

Please get in touch with our practice if you cannot attend your appointment or need to reschedule. All appointment cancellations or rescheduling requests must be made at least 24 business hours before the appointment. Otherwise, you will be charged your regular customary fee for the missed session. For example, to cancel or reschedule a Monday 8:00 AM appointment, you must submit your request by the previous Friday at 8:00 AM.

What is the difference between a psychiatrist and a psychologist?

A psychiatrist is a medical doctor who has completed medical school and is qualified to prescribe medications for various mental health conditions. Psychiatrists undergo extensive training, including 4 years of medical school, 4 years of residency, and optional 1-2 year fellowship programs. This medical background allows them to assess patients from biological/medical and psychological perspectives. In contrast, psychologists complete graduate or doctoral training in psychotherapy but are not medical doctors and, in most states, cannot prescribe medications.

What is psychotherapy?

Psychotherapy, often called “talk therapy,” refers to the treatment of mental health conditions using verbal and psychological techniques. It can be provided by various mental health professionals, including psychiatrists (MD or DO), psychologists (PhD or PsyD), licensed clinical social workers (LCSW), and licensed marriage and family therapists (LMFT). There are many approaches to psychotherapy, such as psychodynamic therapy, cognitive behavioral therapy (CBT), and dialectical behavioral therapy (DBT), among others.

Is it necessary to have a mental health condition to seek talk therapy?

No, you do not need to have a diagnosed mental health condition to benefit from talk therapy. Therapy can be a valuable resource for anyone seeking personal growth, better-coping strategies, or support during challenging times. Many individuals engage in therapy to improve relationships, manage stress, navigate life transitions, or explore their emotions and thought patterns more deeply. Therapy provides a safe and nonjudgmental space to address concerns, set goals, and develop tools for overall well-being, regardless of whether you have a specific mental health diagnosis.

What is a Psychiatrist?

A psychiatrist is a medical doctor (M.D.) specializing in diagnosing, treating, and preventing mental health conditions. With expertise in both medicine and psychiatry, they are uniquely qualified to address the interconnected aspects of mental, emotional, and physical health. Psychiatrists can prescribe medications, provide psychotherapy, and create individualized treatment plans to meet each patient’s unique needs. Those trained in integrative psychiatry adopt a holistic approach, addressing conditions such as anxiety, depression, ADHD, bipolar disorder, and addiction to promote lasting healing, personal growth, and overall well-being.

What is a Child and Adolescent Psychiatrist?

A child and adolescent psychiatrist is a medical doctor (M.D.) specializing in the diagnosis and treatment of mental health conditions in children, teens, and young adults. With advanced training in psychiatry and child development, they are uniquely equipped to address young people’s emotional, behavioral, and psychological challenges. They provide care for a wide range of concerns, including anxiety, depression, ADHD, trauma, and developmental issues, offering personalized, evidence-based treatment plans. Through medication management, therapy, and family-centered support, child and adolescent psychiatrists help nurture emotional well-being and empower young individuals to thrive in their unique environments.

What is a Community and Public Psychiatrist?

A community and public psychiatrist is a medical doctor who addresses mental health at individual and systemic levels. With expertise in understanding the social, cultural, and environmental factors that impact mental health, they focus on providing care that is both patient-centered and community-oriented. This approach translates to personalized, holistic care that considers the broader context of your life, such as social stressors, lifestyle factors, and access to resources. By combining medical expertise with a deep understanding of public health principles, community and public psychiatrists are uniquely positioned to help individuals navigate complex challenges, promote resilience, and foster long-term well-being. Whether addressing mental health conditions like anxiety, depression, or trauma or helping you manage stress and life transitions, the goal is to empower you to lead a healthier, more fulfilling life.

What is an Obesity Medicine Physician?

An obesity medicine physician is a medical doctor (M.D.) specializing in the comprehensive care of individuals with obesity and related health conditions. With expertise in weight management, metabolism, and nutrition, these physicians take a holistic approach to identifying and addressing the root causes of obesity, including medical, genetic, behavioral, and environmental factors. They develop personalized treatment plans that may involve lifestyle modifications, nutritional counseling, behavioral therapies, and, when needed, medications or advanced interventions. The primary goal is to support sustainable weight loss, improve overall health, and reduce the risk of obesity-related conditions like diabetes, heart disease, and hypertension.

What Age Groups Do You Serve?

In our practice, we provide comprehensive psychiatric and wellness care for the following groups:

Children (ages 4–12)

Adolescents (ages 13–17)

Young Adults (ages 18–24)

Adults (ages 25–64)

What Services Do You Offer?

We offer comprehensive psychiatric and wellness services, including diagnostic evaluations, psychotherapy, medication management, and holistic treatment planning. Our expertise spans adult psychiatry, child and adolescent psychiatry, obesity medicine, and lifestyle psychiatry. We emphasize personalized care that integrates traditional psychiatric treatments with holistic approaches, such as nutrition, lifestyle modifications, and evidence-based strategies from lifestyle psychiatry, to promote overall well-being and long-term health.

What Types of Conditions Do You Treat?

We provide comprehensive care for various mental health and wellness concerns across all age groups, offering personalized treatment plans tailored to your unique needs. Conditions we commonly treat include:

Mood Disorders: Depression, bipolar disorder, and mood dysregulation.
Anxiety Disorders: Generalized anxiety, social anxiety, panic disorders, phobias, and obsessive-compulsive disorder (OCD).
Trauma and Stress-Related Disorders: Post-traumatic stress disorder (PTSD) and adjustment disorders.
Attention and Behavioral Disorders: Attention-deficit/hyperactivity disorder (ADHD) and executive functioning challenges.
Eating and Weight-Related Disorders: Obesity, binge eating, and emotional eating, integrating medical, psychological, and lifestyle interventions.
Sleep Disorders: Insomnia and other disruptions affecting overall health and mental well-being.
Substance Use Disorders: Alcohol and drug dependency, with an emphasis on holistic support for recovery.
Psychotic Disorders: Schizophrenia, schizoaffective disorder, and related conditions.
Developmental and Neuropsychiatric Disorders: Autism spectrum disorder (ASD) and tic disorders.
Women’s Mental Health: Perinatal and postpartum mood disorders, and hormonal influences on mental health.
Burnout and Stress Management: Support for managing workplace stress, caregiver fatigue, and life transitions.

In addition to addressing these conditions, we focus on enhancing overall well-being through lifestyle psychiatry, incorporating nutrition, physical activity, sleep optimization, and mindfulness into care plans. Whether you are seeking help for a specific diagnosis or looking to improve your mental wellness, our holistic approach is designed to support your goals and promote long-term health.

What Is Your Approach to Treatment?

At Wellness Psychiatry, our approach is holistic, personalized, and rooted in promoting lasting mental and physical well-being. We integrate traditional psychiatric care with innovative wellness strategies to address the interconnected aspects of your mental, emotional, and physical health.

Our treatment philosophy is centered on:

Comprehensive Assessments: We take the time to understand your unique needs, including your medical history, lifestyle, and personal goals. This thorough evaluation ensures that every treatment plan is tailored specifically to you.
Evidence-Based Care: We combine the latest advancements in psychiatry with proven wellness approaches, offering treatments such as psychotherapy, medication management, and integrative strategies to support your overall health.
Lifestyle Psychiatry: Recognizing the critical role of lifestyle in mental health, we emphasize nutrition, physical activity, sleep optimization, and mindfulness as essential components of care.
Collaborative Partnership: We work with you to develop a treatment plan that aligns with your values and goals, empowering you to take an active role in your journey toward wellness.
Holistic Focus: Beyond treating symptoms, we aim to identify and address the root causes of mental health concerns, fostering resilience and long-term growth.

This comprehensive and integrative approach allows us to address specific mental health conditions and enhance your overall well-being, helping you achieve balance, vitality, and a greater sense of fulfillment in life.

Do you prescribe controlled medications?

We currently prescribe controlled medications if indicated only for patients residing in New York. For patients in Massachusetts, South Carolina, and Wisconsin, if a controlled medication is deemed beneficial for your condition, we can collaborate with your primary care provider or pediatrician to discuss and facilitate a prescription.

Is Concierge Psychiatry available for all patients at Wellness Psychiatry?

At this time, Concierge Psychiatry is exclusively available to a few select patients under the care of Dr. Gupta. This premium service is designed for individuals seeking a highly personalized, flexible, and discreet approach to mental health care. If you want to learn more about eligibility, please get in touch with us directly. House call assessments can be facilitated if requested.