Therapy is not only a commitment of time and effort, but also of finances. We may feel like we can’t afford to get help or we don’t have enough time – but can we really afford to continue the same patterns and putting off building a life worth living? Make your mental health, your happiness, and your life a priority.

How often you have sessions and for what length of time is different for everyone and is tailored to each person’s needs. Some issues can be resolved briefly, while others require sessions over the long term. When you think about the fact that a lot of the issues you’re coping with have likely been going on for years, or even most of your life, it makes sense that it’s not going to go away overnight. Many people actually choose to continue therapy long term so they can have continued support and stay accountable over time.

To make the most of your sessions, we will establish treatment goals in the beginning, add new ones as they arise, and have open communication about how you feel your needs are being met and what you would like to focus on. Throughout treatment we will keep each other up to date on any needed changes including need for increase in frequency of sessions or ability to step down or terminate from sessions.

Prioritizing therapy looks different for everyone – it may mean figuring out what you’re willing to give up like skipping some “retail therapy” or meals out, delaying other life plans for a bit, or discussing rearranging your schedule with your boss or school. Unfortunately, therapy is often seen as the easiest thing to cut, so we continue to repeat unhelpful patterns.

I have listed the general rates below, but I also want to help you make a plan for therapy that works for you. Let me know your needs and barriers and we can problem solve options.

Payment Options

Self Pay 

While paying out of pocket without the help of insurance may seem daunting, eliminating insurance from your treatment allows for the most flexibility and privacy. There are several important benefits to paying on your own:

  • Self pay allows more flexibility in making a treatment plan that fits your needs. Insurance companies try to dictate all aspects of treatment including length of sessions, frequency of sessions, length of treatment, mandated diagnoses for reimbursement, and even deciding that some diagnoses are more deserving of coverage than others – all without having appropriate mental health training or experience.
  • Self pay offers more privacy. Insurance companies require access to client information including but not limited to diagnoses and session notes in order to pay for services and in the event of audits. They may also make some information visible between providers.
  • Self pay avoids unexpected expenses. If insurance decides to refuse to pay for services you received or make a mistake and later “claw back” their payments, you are then responsible for the full session amount. It often takes insurance companies several weeks or even months to process claims and by that time if they have decided they won’t cover something you may have accumulated a sizable balance from recurring sessions that will have to be paid.  In NC, there is no limitation to when an insurance company can claw back their payment so it may happen years after your services have been received.
  • Self pay allows for a private diagnosis or no diagnosis. If you self-pay your diagnosis does not have to be disclosed to anyone and you can get help and support even if you don’t meet criteria for a diagnosis or have a diagnosis that the insurance companies don’t deem to be medically necessary to treat or want to limit treatment options for.  Insurance companies require a diagnosis on your permanent health record to be reported which may be visible to other providers.
  • Self pay provides opportunities for greater independence. Many young adults are on their parent’s insurance until they are 26. However, not all families support mental health treatment or privacy. If using shared insurance there is a chance others on your plan may have access to some of your health information like diagnoses, treatment dates, treatment providers and locations, payments, type of treatment, etc.
  • Self  pay allows for phone sessions and online sessions. Phone sessions can be a convenient way to check in when traveling or unable to make it to the office, but phone sessions are usually not covered by insurance.  Some insurance plans will also not cover online sessions or telehealth. Self-pay allows you the option of participating in sessions when and where you need support.
  • Self pay allows you to work with the therapist of your choice that is the best fit. In-Network vs. Out-of-Network provider classifications and coverage rates can push you towards choosing a provider just because they are covered, even if they aren’t a good fit. By self-paying, you allow yourself to see the therapist that is the best fit for your needs regardless of what companies they are in network with.

Ok, so self pay sounds great, but what if you already have insurance? If you have an insurance I am out of network with your are welcome to self pay the full session fee and I will be happy to provide you with a superbill so that you can submit it to your insurance company for reimbursement. If you have insurance I am in-network with, but would prefer to pay out of pocket you may sign an “opt out” form and choose not to use your insurance. If you want to self pay but can’t afford the full fee talk to me about options and we can try to make a plan that works for you based on need.

A few ways to make paying out of pocket more manageable:

  • Use a Health Spending or Flex Account through your employer or bank
  • Ask your tax preparer if you can deduct therapy costs as an out of pocket medical expense.
  • Pay ahead for sessions to help with budgeting.
  • Review your budget to see if there are other expenses that can be cut down to prioritize therapy.
  • Discuss your barriers and what you feel you can pay each week or month with me and we can work together to build the best plan for your treatment and your finances.

 

Insurance

I am currently In-Network with Cigna and most BCBS plans (some limited network plans excluded). Services may be covered in full or in part by your health insurance plan.  If you are using an insurance that I am in-network with, I am contractually bound to collect from you any contracted rate/copay/patient responsibility amount that insurance deems.  If your insurance doesn’t cover a service or retroactively denies a service, you are ultimately responsible for the full rate of the service.

Insurance information is needed as soon as possible prior to your session, if you choose to use it, so that I can verify your benefits and expected payment responsibilities. If the information is not received at least 24 hours in advance you will be responsible for the full session fee until benefits can be verified. Your actual payment due at time of session is based on your particular insurance plan, if In-Network. I also encourage you to verify information about your coverage and rates directly with your insurance company.

If you have an insurance that I am Out-of-Network with you will be responsible for the full session rate, but a superbill can be provided upon request if you would like to submit it to your insurer for Out-of-Network benefits to be reimbursed by your insurance company to you. Please note that if we have negotiated a reduced rate or if someone else is paying for your services a superbill can not be provided, you can not also submit the sessions for insurance reimbursement, and sessions will not be submitted retroactively.

Rates

More info and additional rates can be found on the professional disclosure statement you will receive prior to your initial assessment. Rates are subject to change based on current local rates and insurance rates. Actual out of pocket expense for individuals with insurance plans that are in-network will be dictated by any contracted rate, copay,deductible, or coinsurance associated with your plan.

  • Initial Comprehensive Clinical Assessment : $180
  • Individual Sessions (appx. 55 minutes): $165
  • Group Office Sessions: $60/per person
  • Animal Care Professional Team Building Equine-assisted Sessions: $150-$450  depending on length of session, topic and materials required, amount of people, etc. Amount of time, price, and activities are negotiable and can be adjusted depending on your specific needs. Price can also be broken down into a per person charge if preferred. Coffee and light refreshments can be included.

 

A plan for future sessions and expected financial responsibility will be discussed during your initial assessment and can be revisited throughout treatment as your financial or life situations change.

24-Hour Cancellation Policy

If you no show your scheduled therapy appointment or cancel/reschedule your session less than 24 hours in advance you will be required to pay a late cancellation fee. The fee is $125 for equine-assisted sessions,  $60 for individual office/telehealth sessions, or $30 for office/telehealth group sessions. You are required to keep an active credit card on file to be used in cases in which the 24 hour cancellation policy is violated, failure to do so may result in termination of treatment. Non-diagnosis based and specialty groups have their own late cancellation policy that is outlined in the terms of each group on a case by case basis. If you are running late text or email me. If you are more than 15 minutes late to your session you will be required to pay the late cancellation fee and reschedule your appointment for a different day. These fees are not covered by insurance and therefore copays and in-network rates do not apply.

Special Note About Equine-Assisted Psychotherapy and Insurance
(Yes, it’s covered)

Equine-assisted psychotherapy sessions are covered by insurance because, even though our office happens to be outdoors, they are still billed as normal mental health office sessions (generally codes 90834 or 90837 for individuals), evidenced based practices like DBT and CBT are used, mental health diagnosis and treatment goals are the main focus of the sessions, and it is an activity used in session – similarly to how if we use a sand tray in session it would not be billed to insurance as “sand tray therapy.”  This is an aspect of this service that we take very seriously in EAGALA and we make sure that we meet all the criteria necessary for mental health sessions. More helpful information can be found on our partner Willow Equine’s site here. If you call and ask your insurance company if they cover “equine therapy” they will likely say no because they are not differentiating that term from hippotherapy, riding therapy, etc. which focus primarily on physical issues not mental health.

*Some of the equine-assisted groups we offer may not be covered by insurance, not because it’s equine-assisted, but because the participants have not participated in an initial assessment and received a diagnosis as required by insurance prior to attending, it may be on a drop-in basis rather than part of a formal plan of treatment, or the group may focus on activities or topics that are not covered by insurance. We clearly reflect the price on information shared about these groups and whether or not insurance is accepted for them.

 

Payment for Non-Mental Health, Team Building, or Support Groups

Some group sessions are not eligible for insurance coverage because participants have not participated in an initial assessment and received a diagnosis or the groups are not based around a specific diagnosis.  Rates for businesses that wish to have team building group sessions, support groups, psychoeducation groups, and some other equine-assisted groups are determined on a case by case basis depending on needs and group size.

 

 

 

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