You’ve done the hard work of finding me. Now let’s talk logistics.

Fees

Listed below are the fees for my services:

All clinical services are billed at $155 per 53 minutes:

• Individual Counseling

• Family Counseling

• Consultation

Diagnostic Assessments are billed at $195 per 90 minutes (necessary for PCIT and SPACE sessions only).

I am not currently in-network with any health insurance companies, however, I can offer a monthly receipt called a “Super Bill” that you may use to obtain out-of-network (OON) coverage directly from your insurance company. I cannot guarantee that insurance will reimburse any portion of it. All clients are responsible for understanding their own mental health insurance benefits. I recommend contacting Member Services typically on the back of your insurance card to determine your benefits. Questions to ask include:

• What is my out-of-network outpatient mental health coverage?

• Do my benefits cover Telehealth or telemedicine?

• What percent does my insurance cover for out-of-network sessions?

• Do I have to meet an out-of-network deductible to utilize benefits?

• How much will I get reimbursed for a 53+ minute psychotherapy session (CPT codes - 90837; 90846; 90847)?

• What is the claim submission process?

Payment Methods

I accept payment in the forms of cash, check, HSA/FSA or credit card. Payment is due at the time of service.

Cancellation Policy

If a session starts late or is terminated early, you will be charged the full fee for the session. If you must cancel your appointment, please contact me at least 24 hours in advance. You will be responsible for 100% of the fee when cancellations are received less than 24 hours in advance, or if you do not show up for your appointment.

Privacy

Notice of Privacy Practices

Good Faith Estimates

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost Under the law, health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.

• You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

• If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.

• If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.

• Make sure to save a copy or picture of your Good Faith Estimate and the bill.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1- 800-985-3059.
No Surprises Act