What is a “Private-Pay” Practice

As an Out-Of-Network provider (OON) I do not bill insurance directly. This means NO insurance authorization delays, NO session limits imposed by a claims reviewer, NO mandated diagnoses on your permanent health record, and NO restriction on the course or focus of our work or your treatment. It frequently means your therapist (me) understands business, places a high value on our time, and arrives to session focused on your needs, rather than overloaded and burnt out from carrying too many clients.

You and I determine what you need, and when we meet.
Care is never terminated due to insurance.

You come first.

Initial Costs: 15 min Consultation is always free. Individual therapy sessions are $250 per 50-minute hour, or $300 for Couples and/or Family therapy. Payment is due at the time of service, with cancellation required 24 hrs in advance to avoid fees.

How to Use PPO Insurance to Reduce Costs

PPO or “Preferred Provider Organization” is a health care plan built to allow optimal health with minimal limitation. The plan is designed to give direct access to Doctors, Therapists, and Specialists who are not limited by contracts with corporate insurance carriers. Most people with a PPO or POS health insurance plan have out-of-network mental health benefits and don't know it — or don't know how to use them.

Here's how it works: You pay the fee at each session. I provide a monthly “superbill” — a standardized receipt with the diagnostic and procedure codes your insurance requires. You submit this to your insurer. Depending on your plan, your insurer reimburses you directly, typically 50–80% of the session fee ($200) after your out-of-network deductible is met.

Reimbursement rates: For many clients with PPO plans through Aetna, Cigna, United, Anthem Blue Cross, Blue Shield, or similar carriers, the effective out-of-pocket cost after reimbursement is $50–120 per session — comparable to or less than a standard, in-network copay after yearly deductibles are factored in.

HMO Plans: HMO is short for “Health Maintenance Organization” and is limited to health maintenance care. HMO plans do not carry out-of-network mental health benefits. If you have an HMO plan, you will pay the full session rate, without reimbursement. Some clients choose to cover the full fee; others find it worth a change to a PPO plan at open enrollment.

How to Check Your Benefits Before We Meet

Call the member services number on the back of your insurance card and ask the following:

• "Do I have out-of-network mental health benefits?"

• "What is my out-of-network deductible, and how much of it has been met?"

• "What percentage does the plan reimburse for an out-of-network therapist after the deductible?"

• "What is your allowed amount for CPT code 90837 (Individual) or 90847 (Family/Couples)?"

That last question is the most important. The reimbursement is calculated as a percentage of your plan's "allowed amount" for that code — not necessarily my full fee. That number tells you the reimbursement per session, and allows calculation of your final out-of-pocket expense.

HSA and FSA Accounts

Therapy is an eligible medical expense under both Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA. If you have an HSA or FSA, you can apply those pre-tax dollars directly to session fees, effectively reducing your medical costs by your marginal tax rate.

Questions?

If you're unsure about benefits or want to think through if this works financially before scheduling a consultation, feel free to reach out. I'd rather you have the full picture than decline to seek support based on a presumed costs that your carrier is billing you for with your PPO plan premium.