Therapist Leaving a Network: Continuity of Care for Clients

Last reviewed: October 7, 2026.

When a therapist leaves an insurance network, existing clients do not automatically lose in-network coverage that day, and they do not automatically keep it either. Until the termination is effective you are still in network. After that, a qualifying client may get a transitional continuity-of-care period, and others may need a single case agreement approved through the plan’s authorization team.

First, pin down when you are actually out

A contract termination takes effect on the date the payer confirms, which is usually months after the notice is sent. Keep billing in network and keep seeing clients under their normal benefits until then. Removing one clinician versus ending the group contract explains how that date is set. When we send a termination request, we ask the payer to confirm the effective date and any continuing transition-of-care obligations in the same reply.

Also make sure the network status you are reacting to is real. We once told a practice that a client’s plan had it out of network and suggested self-pay, then had to walk that back: the payer showed the clinician in network under a different Tax ID, and the discrepancy was still under review. Resolve that kind of record mismatch before you change what clients pay.

Which clients may keep in-network terms

Under the federal No Surprises Act protections CMS describes, a “continuing care patient” whose provider leaves the network can keep in-network cost sharing for up to 90 days. The examples include treatment for a serious and complex condition and other specified situations. It does not say every established therapy client gets 90 more days, and Medicaid, Medicare and state-regulated plans can have their own rules.

Ask the right department

In our experience the provider network or recruitment team is often not the group that grants exceptions for individual members. When we asked one Medicaid plan’s network team whether existing members could continue with a clinician the plan would not contract, it pointed us to its prior authorization department for single case agreements. Kaiser in Washington, similarly, takes out-of-network single case agreement requests through its mental health access center by fax rather than by email.

When you ask, request answers to all of these:

1. Is there a continuity-of-care, transition-of-care, or single case agreement pathway for current members?

2. Who must submit it, on what form, and through which secure channel for member details?

3. Is authorization required per member, and is there a deadline?

4. Once approved, what dates, number of sessions, codes and rate apply?

5. If no pathway exists, what transition process does the plan expect?

Leave member identifiers out of the first question. Send them only once the plan names a secure route.

Single case agreements are per client

A single case agreement covers one member’s care with one out-of-network clinician, usually for a set number of sessions and dates. It does not put the clinician back in network. If you want network status again, that is a new credentialing application. For one payer’s version of this process, see Oscar network gap exceptions for therapists.

Close the loop on billing

• Bill sessions before the termination date as in-network claims, even if they are filed later.

• For sessions under an approved transition period or agreement, check that the remittance applies those terms before moving anything to the client.

• If a client will become out of network, give a clear cost estimate before that date. Out-of-network options are covered in out-of-network billing options for therapists.

Bomi asks payers these questions for the practices it supports and tracks the confirmed dates against claims. Clinical decisions about transfers stay with the treating clinician.

Frequently Asked Questions

Do all my clients get 90 more days in network?

No. The federal 90-day protection is for qualifying continuing care patients, and the plan decides who qualifies.

Can I keep seeing a client after I leave their network?

Yes, but the claims will process as out of network unless the plan approves a transition period or a single case agreement for that client.

Who do I call about a single case agreement?

Usually the plan’s authorization or utilization management team, not provider recruitment. Ask the network team to confirm the route if you are unsure.

Sources

• CMS: if your doctor is leaving your network

• CMS: No Surprises Act provider requirements