You have the right to a “Good Faith Estimate” explaining how much your medical and mental health care will cost. The Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created. The Good Faith Estimate (GFE) does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill. If you are billed for more than this GFE by at least $400, you have the right to dispute (appeal) the bill. You may contact the health care provider or facility listed to let them know the billed charges are higher than the GFE. You can ask them to update the bill to match the GFE, ask to negotiate the bill, or ask if there is financial assistance available. You may also start a dispute resolution process with the U.S. Dept of Health and Human Services. If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 calendar months) of the date on the original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount. Make sure to keep a copy or picture of your Good Faith Estimate in a safe place. You may need it if you are billed a higher amount. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call HHS’s toll free number 1-800-985-3059.
Primary Service(s) and Expected Charges:
*Payment is due at time of service
CPT 90791 (60 Minute Initial Intake Assessment): $175
CPT 90837 (60 Minute Psychotherapy) $150
75 minute $200
45 minute (90834) $150
Missed Appointment/Late Cancel/No Show: $150
Phone calls over 20 minutes: $85
15-20 minute consultation is FREE prior to your intake assessment.
Therapy is a mutual process, and our consultation call with be used to listen to your needs and assess if we are a good fit for each other. My goal is to support you in making the best choices for your needs. If you would like to book a consultation, please visit my connection page.
At this time, all services are cash (aka Private pay) only, and I am considered an Out of Network provider. Some insurance companies will be willing to reimburse part of the cost of your therapy. I can provide a superbill on your behalf.
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