What is an "allowed amount" — and why is my reimbursement smaller than expected?

A: The allowed amount is what your plan decides a service is worth — and out-of-network reimbursement percentages apply to that number, not your therapist's actual fee. It's the most common source of superbill disappointment.

Worked example: your therapist charges $250. The plan's allowed amount for a 90834 session is $130, reimbursed at 60%. You expected $150 back; you get $78. Still real money — $312/month on weekly sessions — but plan on it accurately.

Do this: before starting with an out-of-network therapist, ask your plan: "What is your allowed amount for CPT 90834 in my zip code?" They must tell you. Then do the math with the superbill guide →.

Source: TherapyCalifornia insurance routes, August 2026.