New Client Paperwork

For your convenience, we are now using an online portal to manage administrative materials for my practice. Prior to your first appointment, you will receive an email with login information to access the online patient portal. Please login and complete the following documents:

  1. The patient consent form

  2. The HIPAA form

  3. The patient intake form

  4. Bio sheet

  5. Credit card information sheet

Fees and Insurance

Our standard sessions fees range from $200-$250 per session depending on the duration and type of session. While we do not accept insurance directly, we can provide a superbill for you to submit to your insurance for reimbursement. If you are interested in using insurance to cover session costs, we recommend calling your insurance carrier prior to your first meeting to see what will be covered. You will want to ask the following questions:

  1. “Do I have out-of-network benefits?” In order for our sessions to be covered the answer here needs to be “yes”. If you do not have out of network coverage, you have the option to pay out of pocket or with a health savings plan. All expenses associated with your treatment are tax-deductible. I can provide you with an invoice for session fees for tax purposes.

    If you have out-of-network coverage then proceed to question #2.

  2. “Will I be covered for the following procedures: 90791- a psychiatric diagnostic exam, 90834- a 45 minute psychotherapy session, and 90837- a 60 minutes psychotherapy session.” You will want to have at least the 90791 and the 90834 covered for our purposes. If you are also seeking PCIT services, please ask about the +90785 interactive complexity code. This is a special code indicating a more complicated form of treatment and should increase the amount the carrier can cover. For each code, ask “What is the maximum allowable rate for each code?” This will also help us to understand what will be covered.

  3. Next you will want to inquire about the portion of the session fees that will be covered. Typically this is between 60% and 80% of the session cost.

  4. Finally, ask about your deductible or other out of pocket costs. If you do have deductible, it may be helpful for you to know how much of that deductible you have already met for the year so that you can anticipate when your coverage will begin to apply to our sessions together.

If you have questions, you are not alone. We do find that this seems more complicated on paper than it typically is in practice. Historically, we have not encountered trouble accessing insurance benefits for clients when they have out-of-network coverage. We are glad to help you navigate the process and can tailor treatment to ensure that you maximize your insurance benefits.