"No Surprises Act" Good Faith Estimate & Fees

Rates/Fees:  Appointment fees vary based on length and type of service. Some standard fees are below.

Initial Appointment: Standard--55 minutes $250; Extended--85 minutes $375

Psychotherapy, Clinical Hypnosis, or Consultation (50-55 minutes) $225

Fees for other services are outlined in my practice policies.

Payments: I utilize a HIPAA compliant option for payments with credit cards, including most health savings or flex accounts. Fees are due at the time of service.

Insurance: I am not contracted with any insurance company as an in-network provider. However, if you have a PPO insurance plan that offers you out of network benefits, I'm happy to give you a special receipt (with your diagnosis and visit information) that you can submit to your insurance company to seek reimbursement. Keep in mind there is no guarantee of reimbursement and that your insurance company may request further information about your treatment in order to process your claims. 

Medicare: I am "opted out" of Medicare. If you are (or become) eligible for Medicare, this means that neither one of us would bill/seek reimbursement from Medicare for my services. As part of the opt out process, we must complete a private contract to work together.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.  Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.  

● You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. 

● Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service. 

● If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. 

● Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.