Fees, sliding scale, and out-of-network reimbursement
This practice is private pay and out of network. That arrangement is common and often misunderstood, so this page explains what it costs you, what you may get back, and how to find out before you start.
No cost, no commitment
The first conversation is free.
Up to fifteen minutes by phone. Use it to describe what is going on, ask about fees or the sliding scale, and decide whether to go further. Nothing is charged and nothing is booked unless you want it to be.
Book a free consultationWhat this is
Private pay
You pay for the session directly, at the time of session. Fees are listed below, and a limited number of sliding-scale places exist.
What insurance can still do
Out-of-network reimbursement
No insurer is billed directly, but many plans reimburse part of an out-of-network session. You receive a superbill each month to submit to your plan. Do not assume your insurance is unusable before you have asked: the five questions further down this page will tell you in ten minutes.
Session fees
Private pay. Payment is due at the time of session.
- Individual psychotherapy, 55 minutes
- $200
- Individual psychotherapy, sliding scale
- $135 to $150
- Ketamine-assisted psychotherapy, 60 minutes
- $225
- Ketamine-assisted psychotherapy, sliding scale
- $150 to $175
- Initial consultation
- Free, up to 15 minutes
Payment is due at the time of session. If a fee ever becomes an obstacle to continuing, say so directly rather than stopping quietly; that conversation is a normal part of treatment and not an awkward exception to it.
What out of network actually means.
I am not contracted with any insurance panel. That means your insurer has no negotiated rate with me and does not pay me directly. You pay me for the session, and I give you a superbill: an itemized receipt containing everything an insurer needs to process a claim, including the date of service, the service code, the diagnosis code, my license number, and the amount you paid.
You submit that superbill to your insurer yourself, usually through a member portal or by post, and if your plan includes out-of-network outpatient mental health benefits, the insurer reimburses you directly according to the terms of your plan. The money comes back to you, not to me.
Whether it comes back at all, and how much, is entirely a matter between you and your plan. I cannot promise reimbursement, appeal a denial on your behalf, or guarantee that a particular percentage will be paid. What I can do is provide a correctly coded superbill promptly, every month, so that nothing is delayed at my end.
People choose this arrangement for reasons beyond price. Out-of-network work is not subject to an insurer's authorization of session frequency or its view of what constitutes sufficient progress, and the clinical record stays considerably narrower. For some people that matters a great deal, and for others the reimbursement question is the only one that counts. Both are legitimate.
Five questions to ask your insurer.
Call the member services number on the back of your card and say you are asking about out-of-network outpatient mental health benefits. Write down the answers, the date, and the name of the person you spoke to. Ten minutes on the phone will tell you more than any estimate I could give you.
What is my out-of-network outpatient mental health benefit?
Some plans have one and some do not. This single question tells you whether the rest of the conversation is worth having.
What is my out-of-network deductible, and how much of it has been met this year?
Reimbursement usually begins only after the deductible is satisfied, and the out-of-network deductible is often a separate, larger figure from the in-network one.
What percentage is reimbursed after the deductible is met?
Ask whether that percentage applies to what I charge or to the plan's own allowed amount, which is frequently lower. The difference decides what actually lands back in your account.
Is there a limit on the number of sessions per year?
Some plans cap sessions, or cap them per calendar year, which matters if you are starting late in the year.
Do I need pre-authorization before starting?
A small number of plans require it and will decline claims submitted without it, even retroactively.
Sliding scale
A limited number of reduced-fee places exist: $135 to $150 for individual psychotherapy, and $150 to $175 for ketamine-assisted psychotherapy, depending on individual circumstances.
To ask about one, raise it on the free consultation or in your first message. You do not need to document hardship or make a case for yourself. A sentence is enough: that the standard fee is out of reach and you would like to know what is possible. If a place is available I will say so, and if it is not, I will say that too and suggest other options rather than leaving it ambiguous.
Cancellation policy
Your appointment time is reserved exclusively for you. If you need to cancel or reschedule, please provide at least 24 hours' notice. Appointments canceled with less than 24 hours' notice, or missed without notice, may be charged the full session fee unless there is an emergency or unforeseen circumstance.
Good Faith Estimate
Clients who are not using insurance are entitled to a Good Faith Estimate of the expected cost of care. You will be given one before treatment begins, along with a fuller explanation of your rights.
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