Rates and Insurance
Money is typically a big question up front, so here is the scoop...
I am in--network with Highmark, Cigna, and UPMC. What that means is: If you have Highmark Blue Cross/Blue Shield insurance (this includes out of state plans) Cigna, or UPMC: then I can submit claims on your behalf, and you only worry about your copay and/or deductible. You can always check with the number on your card to find out exactly what your out of pocket expenses will be, as each plan is different.
If you have a different insurance, I can see you as an *out of network provider, if you have an insurance plan that covers out of network (typically PPO type plans). Depending on the plan, we can decide whether I submit claims for you, or if you submit those claims. The good news is, there is typically good coverage on these plans.
If you would prefer, you can also pay out of pocket (self pay) to avoid dealing with insurance, or if you have a high deductible plan and don't want to bother with insurance for your own personal reasons. There are many reasons to not go through your insurance, a big one is for pure privacy, where it is never put on a public record anywhere.
Additionally, to note, is that insurance DOES NOT COVER marital/couple/relational therapy. One quick way to explain this, is that insurance bases reimbursement on a diagnosis of one person (the identified client). In couples work, there is no reimbursable diagnosis for ONE person, as it is the couple working on relational dynamics. Yes, there are v-codes that are diagnosis codes for relationship issues, but they are not reimbursable by insurance. Put simply, in regular couples work there isn't an identified client and a reimbursible diagnosis like depression or anxiety.
Below are my rates, but keep in mind that insurance often covers part or all of my rates, (except for phone consultations and as previously mentioned- marital therapy in most plans) which are as follows:
- Initial Meeting Session 60 minutes: $150
- Individual Session 50-55 minutes: $125
- Individual Session 30-45 minutes: $100
- Couple or Family Session 55 minutes: $150
- Phone Consultations-prorated at same session rate (self pay only)
- Teletherapy (video chat) (Highmark, UPMC, & Cigna are currently covering during COVID Pandemic) and self pay): $125
For a more detailed list of fees please see my financial policies within the intake packet, as there can be other fees that are not covered by insurance in some circumstances.
*For insurances other than Highmark BCBS, Cigna, and UPMC- I am considered an Out of Network Provider. Generally if you have a PPO with another insurance provider, there is still some out of network coverage, so please check your out-of-network coverage carefully by asking the following questions:
- Do I have mental health (or behavioral health) out-of-network insurance benefits?
- What is my out-of-network deductible and has it been met?
- How many out-of-network sessions per year does my health insurance cover?
- What is the coverage amount per therapy session (i.e. allowable amount vs provider fees)?
- Is approval required from my primary care physician?
Depending on your plan and claim submission process, we can discuss whether I provide you with an invoice with all needed information to submit yourself for reimbursement, or if I file the claim for you.
Good Faith Estimate
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.
On our initial visit, there is a lot of information gathering both demographically/ administratively, as well as emotionally or situationally as to why you are seeking help. To allow more time for us to determine what will best help you, please review and complete all forms within the intake packet prior to our first meeting. If you prefer, I have them printed in the office for you and you can come early to complete in the waiting room. PDF files are provided below for your convenience.