Individual
therapy
$200 initial / $175 Follow Up
Initial Session - 1 hour
Follow Up - 45 Minutes
sex therapy
$200 initial / $175 Follow Up
Initial Session - 1 hour
Follow Up - 45 Minutes
couples
counseling
$250 initial / $220 Follow Up
Initial Session - 1 hour 15 minutes
Follow Up - 1 hour
* Virtual Therapy Available for all session types.
* Longer sessions are available by request in 15 minute increments.
I am not in-network with any insurance companies, but I will give you all the information you need to file the claim with your insurance. My focus is on your treatment, but I understand the need to offset the costs and I will help you with it. The amount you may be reimbursed depends on your policy. I recommend that you contact your insurance company to find out exactly what they are willing to cover.
QUESTIONS TO ASK YOUR INSURANCE ABOUT OUT-OF-NETWORK COVERAGE
Therapy may be covered in part or in full by your health insurance plan. Check your coverage carefully by asking your provider these questions:
1. Do I have "out-of-network" mental health insurance benefits?
2. What is my deductible and has it been met?
3. What is my "co-insurance"?
4. How many sessions per year does my health insurance cover?
5. What is the coverage amount per session?
6. Is approval required from my primary care doctor?
HERE ARE THE REIMBURSEMENT CODES SO YOU CAN CHECK WITH YOUR INSURANCE COMPANY
Initial Consultation, 60-minutes (Evaluation) — CPT code 90791
Individual Psychotherapy, 45-minutes follow-up — CPT code 90834
Individual Psychotherapy, 60-minutes follow-up — CPT code 90837
Couples Psychotherapy, 60-minutes follow-up — CPT code 90847
BENEFITS OF PAYING OUT OF POCKET VERSUS USING INSURANCE
All insurance companies mandate that the individual seeking therapy obtain a diagnosis. This is so the insurance company can determine whether THEY feel that therapy is "medically necessary" for you.
Insurance companies typically have the right to audit your treatment plan and progress notes, which compromises confidentiality. They may limit your coverage to a set number of therapy sessions per year, regardless of what you may be going through.
Other things to consider are timing, long-term costs, and availability. Often times your insurance provider may require you to meet a deductible before coverage kicks in, and at times, meeting the deductible can take some time. If you have a set number of sessions and a high deductible, using your insurance may not be the most cost-effective option long-term.
Above all, you are limited to therapists that are only within network so finding the "right fit" may prove to be even more challenging at times.
Considering all of the above, paying out-of-pocket may be a better fit for some. Please feel free to contact me to discuss further.
NO SURPRISE ACT
Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit http://www.cms.gov/nosurprises