Cost and insurance-Psychotherapy
Other Services Available
-- Psychological/psychiatric/mental status exam evaluations for adoption and other purposes
-- Driver's reinstatement evaluation
-- Substance abuse evaluations
-- Employment evaluations
-- Driver's reinstatement evaluation
-- Substance abuse evaluations
-- Employment evaluations
Insurance and Payment
If you have insurance that covers "out-of-network" mental heath benefits, our therapists might be considered an out of network provider for some plans not listed above. If you have such coverage, you may be able to get reimbursed for a part of the cost of therapy. It is your responsibility to seek such reimbursement. Many insurances do not cover certain conditions, even if you have mental health coverage.
AHCCCS insurances including Banner Family Care are not accepted. These insurances ONLY have contracts with the larger agencies in town, such as La Frontera, COPE, CODAC, AZCA, etc.
Follow These Steps to Clarify Your Mental Health Benefits:
1. Call your insurance company. Use the numbers on the back of your card.
2. Ask:
a. Does my policy cover mental health benefits- outpatient behavioral health visits?
b. Do I have a deductible? Have I met the deductible?
c. Do I have a co-pay? How much is it?
d. How many sessions per calendar year does my policy cover? Does it cover family therapy? Couples therapy?
Payment
We bill clients directly before each session for co-pays, co-insurance, and deductibles. Cash, major credit cards, debit cards, and checks are accepted for payment at the time of service.
Cancellation Policy
Please notify the office at least 24 hours in advance if you need to cancel to avoid being charged for the session.
Fees
The following is a detailed list of expected charges
90791 Initial Diagnostic Evaluation/Intake (if paying cash at the appointment we provide a $75 discount off the $250) $250 or $175 cash
90832 Psychotherapy, 16-37 minutes (a discount of $35 off $160 for paying cash) $160 or $125 cash
90834 Psychotherapy, 38-52 minutes (a discount of $55 off $180 for paying cash) $180 or $125 cash
90837 Psychotherapy ≥ 53 minutes (This fee is the hourly rate used for all calculations)
(a discount of $75 off $200 for paying cash) $200 or $125 cash
90839 Psychotherapy for a Crisis (30-74 minutes) (a discount of $65 off $240 for paying cash) $240 or $175 cash
90840 Psychotherapy for a Crisis (add on code for each 30 mins) (a discount of $32.5 off the price for paying cash) $120 or $87.5 cash
90846 Family Psychotherapy without Patient Present, 26-50 minutes (a discount of $75 off $200 for paying cash) $200 or $125 cash
90847 Family Psychotherapy with Patient Present, 26-50 minutes (discount of $75 off $200 for paying cash) $200 or $125 cash
90853 Group Psychotherapy $25-50
Cancellation Fee (your therapist requires a 24-Hour cancellation notice) $125
You are responsible for the fee if the appointment is missed
Production of Records paper, letter, completion of forms for disability, for medical leave, etc. $25
Production of Records fax $13.15
Legal Fees/Home visits per hour prorated to the minute $300 an hour
YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS
(OMB Control Number: 0938-1401)
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a co-payment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care - like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:Emergency services. If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as co-payments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-of-network providers can’t balance bill you unless you give written consent and give up your protections.
You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have the following protections:
If you believe you’ve been wrongly billed, you may contact: www.cms.gov/nosurprises. Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.
AHCCCS insurances including Banner Family Care are not accepted. These insurances ONLY have contracts with the larger agencies in town, such as La Frontera, COPE, CODAC, AZCA, etc.
Follow These Steps to Clarify Your Mental Health Benefits:
1. Call your insurance company. Use the numbers on the back of your card.
2. Ask:
a. Does my policy cover mental health benefits- outpatient behavioral health visits?
b. Do I have a deductible? Have I met the deductible?
c. Do I have a co-pay? How much is it?
d. How many sessions per calendar year does my policy cover? Does it cover family therapy? Couples therapy?
Payment
We bill clients directly before each session for co-pays, co-insurance, and deductibles. Cash, major credit cards, debit cards, and checks are accepted for payment at the time of service.
Cancellation Policy
Please notify the office at least 24 hours in advance if you need to cancel to avoid being charged for the session.
Fees
The following is a detailed list of expected charges
90791 Initial Diagnostic Evaluation/Intake (if paying cash at the appointment we provide a $75 discount off the $250) $250 or $175 cash
90832 Psychotherapy, 16-37 minutes (a discount of $35 off $160 for paying cash) $160 or $125 cash
90834 Psychotherapy, 38-52 minutes (a discount of $55 off $180 for paying cash) $180 or $125 cash
90837 Psychotherapy ≥ 53 minutes (This fee is the hourly rate used for all calculations)
(a discount of $75 off $200 for paying cash) $200 or $125 cash
90839 Psychotherapy for a Crisis (30-74 minutes) (a discount of $65 off $240 for paying cash) $240 or $175 cash
90840 Psychotherapy for a Crisis (add on code for each 30 mins) (a discount of $32.5 off the price for paying cash) $120 or $87.5 cash
90846 Family Psychotherapy without Patient Present, 26-50 minutes (a discount of $75 off $200 for paying cash) $200 or $125 cash
90847 Family Psychotherapy with Patient Present, 26-50 minutes (discount of $75 off $200 for paying cash) $200 or $125 cash
90853 Group Psychotherapy $25-50
Cancellation Fee (your therapist requires a 24-Hour cancellation notice) $125
You are responsible for the fee if the appointment is missed
Production of Records paper, letter, completion of forms for disability, for medical leave, etc. $25
Production of Records fax $13.15
Legal Fees/Home visits per hour prorated to the minute $300 an hour
YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS
(OMB Control Number: 0938-1401)
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a co-payment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care - like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:Emergency services. If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as co-payments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-of-network providers can’t balance bill you unless you give written consent and give up your protections.
You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have the following protections:
- You are only responsible for paying your share of the cost (like the co-payments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
- Your health plan generally must:
- Cover emergency services without requiring you to get approval for services in advance (prior authorization).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
If you believe you’ve been wrongly billed, you may contact: www.cms.gov/nosurprises. Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.