Every New York therapist who takes insurance eventually asks the same question: should I keep this panel? The answer is rarely emotional. It is arithmetic. Here is the calculation we run with clients before they drop or add a payer, and the three situations where dropping is clearly the right move.
Step 1: Know your true rate per panel
Pull the last 90 days of paid claims for each payer. Divide total paid by number of sessions. That is your real reimbursement, not the contracted rate. In New York City, commercial panels for a 90837 session often land anywhere from the low $90s to the high $140s depending on license type and payer. Many therapists are surprised by how far apart their panels are.
Step 2: Add the hidden cost
Time spent on claims, denials, re-credentialing and phone calls is not free. If a panel denies 12% of claims and each denial costs 25 minutes to work, that panel’s real rate is lower than it looks. Payers that require authorizations or frequent eligibility checks cost more to serve.
Step 3: Compare to your self-pay reality
Not your self-pay fee. Your self-pay reality: how many of your current clients on that panel would stay at a self-pay or sliding rate, and how quickly you could refill the rest. A full practice with a waitlist can absorb dropping a low payer. A new practice usually cannot.
Three times dropping a panel is clearly right
- The real rate is more than 30% below your other panels and you have a waitlist.
- The payer’s admin burden is eating more than two hours a week and you cannot afford to delegate it.
- Your clinical focus has shifted and the panel sends clients you are no longer the right fit for.
What to do before you drop
Check your contract’s notice period (often 60 to 90 days). Give current clients written notice with options: continue out of network with a superbill, transition to self-pay, or get a referral. Update your directory profiles the same day the panel ends. Do not ghost a payer; it can affect future re-credentialing.
What to do instead of dropping
Often the better move is not dropping the panel but fixing the denials. A panel that pays $110 with 12% denials becomes a $125 panel when the denials get worked. That is what a few hours a week of billing support actually buys.
Quick answers
How much notice do I have to give to leave an insurance panel in New York?
Check your participating provider agreement. Most require 60 to 90 days written notice. You also have an ethical duty to notify current clients and offer transition options.
Should a new therapist in New York drop low-paying panels?
Usually not yet. A new practice needs volume more than margin. Build a full caseload first, then drop the lowest panel once you have a waitlist.
Can I stay in network with some panels and go self-pay for others?
Yes. Many New York therapists keep two or three strong panels and take self-pay for the rest. The key is a clear fee policy and a Good Faith Estimate for self-pay clients.
Ready to talk? MBBCS is a clinician-owned practice management team in Brooklyn serving therapists across New York. Book a free 20-minute consult or get a ballpark estimate in 30 seconds.
