Insurance and Fees

All Fees are Paid by the Client at the Time of Service

‍ I am in-network with Blue Cross Blue Shield health care plans.

I also accept clients who have other insurance plans with out-of-network benefits and most preferred provider organization (PPO) plans.

It is important that you contact your insurance and get detailed information about your mental health benefits.

See the questions to the right for things to ask when you contact your insurance:

How many sessions per calendar year does my plan cover for mental health/behavioral health?
How much of that deductible has been met for this year?
When does it reset?
Do I need pre-authorization for psychotherapy?
Do you cover/provide the same rate for tele-health services?
What is my deductible?

‍For clients who have other insurance plans with out-of-network benefits:

Clients are responsible to check with their insurance carrier to ask about out-of-network benefits.

Call the member services number on the back of your health insurance identification card and ask if you have out-of-network benefits for behavioral health services. If you do, ask them the rate of reimbursement, or how much they pay you back per session.

Clients are encouraged to verify whether their insurance carriers reimburse for tele-health therapy services before incurring any costs. Clients receive monthly documentation of services received and payment made (super bill). Clients are responsible for submitting super bills to their insurance carrier for reimbursement.

Out-Of-Pocket Fees (Fees are subject to change.)
‍
If I am not in-network with your insurance or if you choose to not use your insurance and pay for the services yourself, I will provide you a “Good Faith Estimate” of the costs of services.

Please see the “No Surprises Act” below for more information on your rights as an out-of-network and/or self-pay client.

$200 per 38-52-Minute Session (This is the default session length)
Billing Code 90834
$230 per 53-60 minute session (by prearrangement only)
Billing Code 90837
$240 per 50-60 minute couples/family therapy session
Billing Code 90847
$240 per 6-minute intake/psychiatric diagnostic evaluation (1-2 initial sessions)
Billing Code 90791 & 90792

Payment

Clients pay the service fee at the time the service is provided by use of a credit/debit card or FSA/HSA card.

All missed appointments and sessions cancelled with less than 24-hours notice must also be paid for in full at the time of the scheduled appointment.

Auto-payments are arranged as part of the registration process for treatment and contract for services.

‍Specific details of financial policies and payment responsibilities and expectations are provided to new clients at the time they contract for psychotherapy services as part of the treatment agreement and registration packet.

No Surprises Act

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

‍What is “balance billing” (sometimes called “surprise billing”)?
‍When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in network facility but are unexpectedly treated by an out-of-network provider.

‍You are protected from balance billing for:

Emergency services
‍If you have an emergency medical condition and get emergency services from an out-of network provider or facility, the most the provider or facility may bill you is your plan’s in network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

‍Certain services at an in-network hospital or ambulatory surgical center When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

‍You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
Your health plan generally must:
Cover emergency services by out-of-network providers.
Base what you owe the provider of facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
Cover emergency services without requiring you to get approval for services in advance (prior authorization).
Count any amount you pay for emergency services or out-of-network services towards your deductible and out-of-pocket limit.
If you believe you’ve been wrongly billed, you may contact https://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
Visit https://www.cms.gov/nosurprises for more information about your rights under federal law.

The contents of this document do not have the force and effect of law and are not meant to bind the public in any way, unless specifically incorporated into a contract. This document is intended only to provide clarity to the public regarding existing requirements under the law.