Fees and Insurance

Fees & Insurance

WHAT IS THE COST OF THERAPY?

Our standard fee for individual and couples counseling and therapy services are as follows:

Individual Sessions 55 minutes: $150.00

Individual Sessions 80 minutes: $200.00

Couple Sessions 55 minutes: $160.00

Couple Sessions 80 minutes: $200.00

Initial phone consultation: No charge

Diagnostic Evaluation Session $175.00

Our professional rate is considered standard for licensed clinical social workers and/or licensed clinical professional counselors who practice in our local area, based on our expertise, education, and years of experience.

WILL INSURANCE PAY FOR MY SESSIONS?

Is it true that for my insurance to pay for therapy I have to have a diagnosable mental health disorder?

Yes, you must be given a diagnosable mental health disorder in order for insurance to pay for therapy. Insurance companies will not pay for therapy unless there is a mental health disorder code on the receipt/bill. This is extremely unfortunate because many people come to therapy to improve their lives and to work on something they are struggling with, and that absolutely doesn’t mean they have a mental illness.

Yet, in the eyes of insurance companies, in order for them to consider payment, therapy recipients must have a diagnosed mental health disorder. This concerns some people because once that code is assigned to you within your health insurance record, it never goes away. Every future insurance application (life, disability, medical) form you fill out may require you to list that you were treated for a mental health disorder.

If you want to use your insurance to help cover the costs of your therapy sessions, we will discuss if your symptoms meet the criteria for a mental health disorder and if the diagnosis is appropriate. You will need to agree to it and then make the final decision if you want to report that information. We don’t believe labeling is always helpful or necessary, but we do understand sometimes people need to utilize the financial assistance from their health insurance provider to help cover the costs of therapy.

WHAT IF I HAVE PRIVACY CONCERNS?

If you are concerned about your privacy and being given a mental health disorder diagnosis, you have many options. You may consider paying for therapy out of pocket as you do for other personal services you value. A lot of people choose this option, as it allows for them to have more autonomy over their therapy experience. Knowing that you do not have to receive a mental health disorder diagnosis and be pathologized for seeking help is often a relief.

Also, to be assured that your personal data and the details of your therapy treatment will not be shared with an insurance company and be in a permanent electronic health record is a great benefit. When you pay for counseling yourself, your complete privacy is assured within the limits of state and federal laws. In addition to privacy, flexible scheduling, variable session lengths, and possible online sessions when you travel are things that can help make therapy work best for you.

DO YOU TAKE MY INSURANCE, AND WHO CAN ANSWER MY INSURANCE QUESTIONS?

Presently, our providers are in-network providers for Blue Cross Blue Shield, Blue Choice, United HealthCare, Medicare (not Medicaid) and out-of-network providers for other all other insurance companies. We can discuss how billing insurance works for in-network and out-of-network plans during your phone consultation.

If you have more questions about your insurance coverage, please speak with your insurance company directly. We encourage you to jot down all of your questions and contact your insurance company who can provide you with the most accurate information about your individual policy. Just look at the back of your card and call the number that is listed for mental health and/or behavioral health services. Below are some questions I encourage you to add to your list.

Is approval required by my primary care physician?

Do I have mental health counseling and/or marriage counseling benefits?

Do I have outpatient mental health benefits for non-preferred providers/out of network providers?

What is my deductible and has it been met?

How many sessions per the calendar year does my plan cover?

What is the coverage amount per therapy session?

Where should I send a superbill for reimbursement?

CAN I USE A HSA OR FSA FOR THERAPY?

Yes, you can use a Health Savings Account or Flexible Spending Account for therapy and counseling services. Using a pre-tax Flexible Spending or Health Savings Account for therapy is an excellent way to save some money and avoid privacy issues with insurance companies. Unlike using your health insurance for counseling, this route may not always require you to provide a mental health diagnosis.

WHAT FORMS OF PAYMENT DO YOU ACCEPT?

We can receive your payment by way of check, cash, credit, or flexible spending account, or health savings account card. We request that you place a FSA, HSA, or credit card on file so we can maximize our therapy session time together and leave the billing and payment process to happen behind the scenes and outside the therapy session.

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