Questions to ask insurance:
Do I have mental health insurance benefits?
What is my deductible and has it been met?
How many sessions per year does my health insurance cover?
What is the coverage amount per therapy session?
Is approval required from my primary care physician?
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.
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-
PRIVACY ACT STATEMENT: CMS is authorized to collect the information on this form and any supporting documentation under section 2799B-7 of the Public Health Service Act, as added by section 112 of the No Surprises Act, title I of Division BB of the Consolidated Appropriations Act, 2021 (Pub. L. 116-260). We need the information on the form to process your request to initiate a payment dispute, verify the eligibility of your dispute for the PPDR process, and to determine whether any conflict of interest exists with the independent dispute resolution entity selected to decide your dispute. The information may also be used to: (1) support a decision on your dispute; (2) support the ongoing operation and oversight of the PPDR program; (3) evaluate selected IDR entity’s compliance with program rules. Providing the requested information is voluntary. But failing to provide it may delay or prevent processing of your dispute, or it could cause your dispute to be decided in favor of the provider or facility.
Your insurance provider may reimburse you for a portion of your fees. Please check your out-of-network benefits. Upon your request, you will be provided a statement to submit to your insurance company.
Insurance - Out of network
Health Savings Account
If you have a health savings account (HSA) or a flexible spending account (FSA), we are able to accept payments using the credit cards provided by your health insurer.
Appointment cancellations and rescheduling require 24 hours notice. Otherwise the client will be charged a fee of $60.
Reduced Fee: Please call regarding our reduced fee [limited basis]
- Individual Session [covers a child, teen, or adult] $150
- Family Session [covers two or more people] $150
- All sessions are 50-60 minutes in length unless other arrangements have been made.
- A 10 minute consultation via phone is offered at no charge to prospective clients.