Psychotherapy Rates and Payment: Self-Pay, Out-of-Network & In-Network

Self-Pay Rates & Benefits

• $250 for an initial 60 minute intake session
• $200 for follow up 55-minute sessions
• If you have health insurance but choose not to submit to your insurance plan, the above self-pay rates will apply.

While understandably it is not always an option, receiving therapy without going through insurance claims provides the benefits of increased privacy and confidentiality.  There will be no paper trail with insurance to identify you with mental health diagnostic codes so you won’t have to worry about this impacting future employment, life insurance, applying for loans or anything else.  Insurance can also place limitations on the number of sessions allowed as well as the length of sessions.  Private pay does not have any of these restrictions.

 

Out-of-Network Insurance

This means that I am not an in-network contracted provider with your insurance company.  Depending on your insurance plan benefits, you may be able to submit an “out-of-network claim” and get reimbursement directly from them.  In this case you would pay the above self-pay rates for your sessions up front and I will provide you with a receipt and a completed health insurance claim form to submit to your insurance company.  The amount of the reimbursement will depend on your particular plan but is usually a percentage of the billed amount, often 60% – 80%.

Since everyone’s policy is different, even within the same insurance company, it is important to know and understand your coverage, as you will be responsible for the bill incurred.  Before your scheduled appointment therefore, it is recommended that you call the customer service number on the back of your insurance card to verify how your plan compensates for out-of-network psychotherapy services.  It is helpful to ask the following questions to determine these benefits:

• Does my health insurance plan include out-of-network mental health benefits?
• What is my co-pay for an in-network mental health provider? What percentage of the billed amount will be reimbursed by the insurance company for an out-of-network provider?  (Sometimes the difference is not that great.)
• Do I have a deductible?  If so, what is it and have I met it yet?  Do my out-of-network reimbursement benefits kick in before or only after I have met my deductible?
• Does my plan limit the number of sessions I can have each calendar year? If so, what is the limit?
• Do I need written approval from my primary care physician in order for these services to be reimbursed?

 

In-Network Insurance

I am currently an in-network contracted provider with the following insurance companies however I am accepting a limited number of new insurance clients:

• Anthem Blue Cross & Blue Shield • Cigna • Medicaid/Husky • Medicare • Oxford  • UBH • UHC • UMR

For In-Network you are only responsible for your co-payment.  In the case of Husky or Medicare with secondary insurance, there is no copayment.  It is advisable to contact your insurance company before your first session to determine your copay amount, deductible, how many visits are allowed per year and whether you need prior authorization from your primary health provider for out-patient mental health services.

 

Payment Method

• For Self-Pay or Out-of-Network clients, payment is accepted by cash, check, Venmo or credit cards at the time of service.
• For In-Network insurance clients, copays are payable by cash, check or Venmo at the time of service.
• There is no copayment for Medicaid/Husky as well as for many Medicare clients with secondary insurance.

 

Cancellation and Missed Appointment Policy

 

Any Other Questions

I will do my best to answer any questions you may have.

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