Rates

Individual Psychotherapy - $200 per 50-minute session

• My fees include notes that I send to clients after each session that review the content of the session along with any relevant handouts, journal prompts, readings, and suggestions. In this way, the therapy process can be continued at home.  

• Many of my clients begin to experience a decrease in the intensity of emotional distress within the first 6-8 sessions and may move to therapy sessions every other week or as needed. Clients can use their time in between sessions to review their notes and return to suggestions and readings they may not have had time to fully engage in.

• I am committed to providing high quality, individualized care. This means flexibility in scheduling, including same day appointments, therapy "as needed," and email or phone contact available in between sessions. This also means consistent review on my part for each client of therapy goals, motivation, and effectiveness. 

• 10-20 sessions is the recommended amount for the cognitive behavioral treatment of most anxiety disorders. The number of sessions can vary depending on severity of anxiety, years with anxiety disorder, life situation, trauma history, and how well cognitive behavioral therapy matches your goals and learning style.

• Lectures and speaking engagements are charged at $50 for each 15-minute increment, similar to the fee for therapy. However, I do offer many lectures free of cost. Contact me for more details.

CANCELLATION POLICY 

• Appointments are made to reserve a specific time slot for you, and therefore, a minimum of 24 hours' notice is required for rescheduling or cancelling an appointment. A cancellation fee of $50 will be charged for sessions missed or rescheduled without sufficient notification. Most insurance companies will not reimburse for missed sessions. 

INSURANCE 

• I do not serve on the panels of managed care companies which means that you will be responsible for paying all fees in full at the end of the session. With self-pay, you can be assured that you are getting the best available treatment without restrictions and based on your needs and desire.

• If you prefer to use your insurance benefits, I will provide you with documentation that can be submitted to your insurance company as you may be able to receive some reimbursement with me as an out-of-network provider. Your insurance company will determine whether to reimburse you or not and will likely request personal information about our therapy sessions to determine your reimbursement. If this occurs, I will maintain as much discretion and confidentiality as is possible.   

If you are going to use your health insurance, call them (there may be a separate phone number for mental health or behavioral health) and ask: 

• Do they pay for mental health services? Do they pay for the services of a clinical psychologist?  

• Do they cover out-of-network providers? And if so, what is the reimbursement rate (amount insurance pays per visit) for an out-of-network provider (vs in-network)? What is the co-pay?

• Is the coverage for parity and non-parity diagnoses the same? If not, how do they differ (OCD, Panic, and Major Depression are considered parity diagnoses and are covered similarly to medical illnesses whereas other anxiety disorders may not be covered in the same way)?

• What is the deductible and of the out-of-pocket maximum? How much has already been met?

• What is the maximum number of visits per calendar year?  Maximum amount paid per calendar year?

• Is authorization required? Are there any other limitations or exclusions for my coverage?

Negotiating payment and insurance can be a confusing process, especially for someone in the middle of a crisis, so if at any time this information becomes too overwhelming, just give me a call as I have helped many previous clients through this process. 

Benefits of the Self-Pay Model vs Managed Care Model

Limitations on length of treatment and type of treatment: Treatment is only authorized by insurance companies if a reviewer determines that the treatment conforms to the policies set by the company. This reviewer assesses the severity of your problem, your motivation for treatment, and whether treatment is necessary, and then determines whether you will be reimbursed. This reviewer need not have any mental health experience despite being responsible for making these very important decisions about your treatment. In addition, managed care companies encourage very brief treatment and favor the use of medication over psychotherapy. 

Choosing your own therapist: Self-pay and out-of-network benefits allow you to choose a therapist that has the qualities and qualifications you are looking for.

Privacy issues: To justify treatment and determine reimbursement, insurance companies will require disclosure of information about a client's most dysfunctional behaviors. Treatment plans, progress notes, and a diagnosis may be required. Oftentimes, this information is put into a data bank and it is not always clear who has access to the information (some employers have been able to access information from their employees' insurance companies), how this information is protected, and how this may affect the client's future abilities to acquire insurance coverage in the future (health insurance, life insurance, disability).  

Managed care is a business: Managed care companies will often make treatment decisions based on cost rather than the needs of the clients. Being a business, managed care companies also use profits for advertisements, executive salaries, political lobbying, and shareholders.

Labeling sickness: Managed care companies often require treatment to be "medically necessary" for it to be covered. This means that a psychiatric diagnosis is required regardless of your reason for seeking therapy. Many clients come to therapy for issues such as self-growth, stress-management, or habit change, which are issues that may not warrant a psychiatric diagnosis. 

Cost-benefit analysis: All health insurance providers will be different but with in-network providers, insurance companies typically cover 80% of the fee set by the managed care company, which usually mean a cost of about $10-20 for the client. Thus, an in-network provider is the most cost-efficient choice. I am not on any insurance panels, and thus, am not an in-network provider for any insurance. If a client sees a therapist who is an out-of-network provider (as I would be), the insurance company usually covers the same 80% of the fee set by the managed care company, but because the therapist may charge more than that set fee, the client is left having to pay the difference. Thus, with an out-of-network provider, an insurance company may pay 80% of $100 (or whatever amount they set) but because my fee is $200, this means the cost to the client is still about $120. The savings of $100 can be significant for some, while others feel it is not worth using insurance for this purpose.