Presently, my out of network clinical fees are $250 for the initial consultation session (CPT 90791) and $165 for subsequent individual or family therapy sessions (CPT 90834 and 90847, respectively). I currently do not participate with any insurance plans. I have also “opted out” of participating with Medicare.
I am glad to help those patients participating with a Preferred Provider (PPO) or Point of Service (POS) plan with any necessary preauthorization forms and statements to maximize their out of network benefits. Patients are encouraged to contact their insurance plans to find out what type of authorization is needed, and what treatment plans need to be completed. They are also encouraged to check on any deductible amounts, what percentage will be covered once the deductible is met, and what the “reasonable and customary” amounts are for sessions.
Although full payment is expected at the time of the visit, I can electronically file a claim for the services provided to you. However, if additional phone calls are required due to claim issues, the client is responsible for making any follow up calls or additional corrected claim filing. You can also be provided with a monthly statement that includes all necessary information to file a claim yourself or to use with your Health Service Account or Flex Spending Account.
Although I encourage checks or cash payment at the time of service, I also accept Master Card and Visa as a courtesy to my patients. Health Service Accounts (HSA) cards and Flex Spending Cards may also be used at my office.