No Surprises Act
In compliance with the No Surprises Act that went into effect January 1, 2022, all healthcare providers are required to notify clients of their Federal rights and protections against “surprise billing.” This Act is designed to protect patients from surprise bills for emergency services at out-of-network facilities or for out-of-network providers at in-network facilities, holding them liable only for in-network cost-sharing amounts. The No Surprises Act also enables uninsured patients to receive a good faith estimate of the cost of care.
Insurance Options: In-Network
If you have Aetna, All Savers, Anthem/BCBS, Carpenters’, Cigna, Meritain, Optum, or United Healthcare insurance, I am an “in-network” provider for you. Each insurance company has its own set reimbursement rates for your counseling sessions, which is called a “contracted rate”. Every insurance plan is different; some clients pay a coinsurance or copay (a fixed amount you pay for each session cost), some individuals have to pay the entire contracted rate up until they meet their deductible (what you pay before your insurance company starts to cover any costs), and others have already met their deductible and may not need to pay anything for their counseling sessions. Because everyone’s insurance plan is different, it may be helpful for you to call your the customer service or mental health benefits phone number on the back of your insurance card to determine exactly what your cost would be.
Fees and co-pays are due at the time of service. Although cash or check is the preferred method of payment, you may also pay by HRA, HSA, or credit card.
If your insurance carrier is not listed above, I am an out-of-network provider for you. Some insurance companies offer out-of-network benefits, which reduces your out of pocket cost. If you do not have out-of-network benefits with your insurance plan, you may want to consider being a self pay client (see below). If you DO have out-of-network benefits with your insurance plan you can pay my published fee at the time of your counseling appointment and I will provide you with a detailed receipt showing your payment. You may then submit your receipt to your insurance company for reimbursement.
If you would like to see me as an out-of-network provider, please contact the customer service number on the back of your insurance card to determine your benefits. When you call your insurance company, inquire what your outpatient mental health benefits are for an out-of-network provider who is a master’s-level licensed professional counselor. You may get price quotes for the CPT service codes of 90834 (a 45 minute office visit) or 90837 (a 60 minute office visit). If you want to turn in your receipt for reimbursement, most companies also require a diagnosis.
Private Pay / Self Pay
If you do not have mental health benefits with your current insurance plan and/or you do not have insurance, you can be a “Private Pay” or “Self Pay” client. This means that you simply pay my published rate for your counseling sessions.
Effective 12/1/2022, my published rates are as follows:
- $150 for an initial 50 minute session (CPT code 90791)
- $125 for a 55-60 minute session (CPT code 90837)
- $100 for a 45-minute session (CPT code 90834)
- $60 for a 30 minute add-on session (private pay option only)
Cancellations / No Shows
This is a difficult topic for most small businesses that operate on a fee-for-service basis. Having mutual respect for time invested in the counseling process is important, as is mutually extending grace when something happens that prevents the appointment from taking place (e.g. illness, severe weather, childcare issues, etc.). Please know that there is grace offered for emergencies that may arise; these policies are simply in place to set healthy boundaries with clients and to establish a mutual respect of time and services.
If you need to cancel/change an appointment, please do so with at least a 24-hour notice. This allows your reserved appointment time to be offered to others who are seeking services. Please note there is a fee of $60.00 if you cancel with less than a 24 hour notice and/or do not show up for your scheduled appointment. Please be aware that insurance companies do not reimburse for late cancellations and/or no show appointments.