Fees

Psychotherapy Payment Arrangements

Private Pay

Fee setting, appointment time and interval between appointments, and cancellation policies are determined by each psychotherapist. Some therapists offer a sliding scale or will adjust their fees on a case-by-case- basis, while other therapists have established fees for their services. The number of sessions and interval between sessions is discussed with and determined by you and your psychotherapist.

Client confidentiality is a central part of the therapeutic relationship. When you choose to work with a psychotherapist in private practice with a private pay arrangement, you may contact any therapist you wish without pre-authorization. The number of sessions is open-ended rather than pre-determined and possibly limited by the insurance plan coverage. Psychiatric diagnoses and clinical notes are not submitted to your insurance company to be entered into a data base of pre-existing psychiatric or psychological treatment. Billing and private information are confidentially maintained by your therapist and are never faxed or shared with anyone without your written authorization.

Insurance and Managed Mental Health Care  

Some Questions to Ask Your Insurance Provider About Your Coverage

• Do I have mental health benefits under my insurance plan?
• Do I need pre-authorization to start therapy?
• What is my deductible and has it been met?
• Must I choose a therapist from the health plan provider list or can I choose a therapist out of network?
• How many sessions per calendar year will my plan cover, and what is my co-payment?
• Does my plan have restrictions regarding my presenting problem or diagnosis?
• Is couple or family therapy covered?
• What Information about me does the insurance company require, and what is considered to be confidential?

Health Insurance – Client pays monthly premium individually or through an employer group, who negotiates terms with the insurance company. These include your annual deductible and the percentage of reimbursement you will receive based on customary rates for your diagnosis and type of service provided. In most cases you can choose any therapist you wish without pre-authorization. To receive your reimbursement, psychiatric diagnoses and clinical information are submitted to your insurance company and entered into a data base, which then tracks your record of pre-existing psychiatric treatment. There may be restrictions regarding covered diagnoses and number of sessions allowed per calendar year.

Preferred Provider Organization (PPO) – Similar to insurance coverage above. However, your insurance company has negotiated rates with specific providers. You must choose a psychotherapist from their pre-authorized list of providers, and pay a pre-determined co-payment. The therapist will also receive a negotiated portion of the fee from the insurance company. Some PPO’s will allow you to see a therapist “out of network” with a higher deductible and copayment for which you are responsible.

Health Maintenance Organization (HMO) – An organization that provides a wide range of comprehensive health care services to patient members who then chose care from a network of providers within the organization. There is no ”out of network” option as all services are provided within the organization.

Medicare/ Medi-cal – These plans may require that you seek mental health services through the county in which you reside. You may be referred to a local clinic or you will be provided with referrals to a therapist in your geographic area authorized to accept this payment plan for services.