Fee Schedule

PRIVATE PAY

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In order to use insurance for counseling you must meet criteria for a mental health diagnosis. The diagnosis is reported to your health insurance company and becomes part of your medical record. 

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Some people choose not to use their health insurance for therapy.

Self-pay is an option if you do not have health insurance or do not want to use your health insurance for counseling.

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*Pay  Scale:

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                             Intake   /    Regular Session 

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*Psychiatry            $300     /    $200  existing patient.  

(Med Mgmnt)

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*Psychotherapy      $150   /      $130  existing patient

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**We also offer discount packages at a discount rate of 3 for $240 paid in groups of three upfront. Appointments must also be scheduled at this time , but you are welcome to change them if needed. This reduced fee is for Self-Pay clients .

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*We offer sliding-scale therapy with licensed  LPC  interns (Counselors in Training) -$50

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*We do accept most Insurance company plans, see list of providers to see if it is covered.

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*Thanks to HIPAA/HITECH regulations we now have the ability to have our patients opt-out of filing their health insurance. The only caveat is that you must pay in full. You will need to sign an Opt-out agreement , but then no information will be released to your insurance company . 

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****Insurance Disclaimer: A quote of benefits and/or authorization does not guarantee payment or verify eligibility. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at the time of service. Any and all services not covered by an individual’s insurance are required to be paid by the individual to whom services are rendered.

***Reunification  (Not Covered by Insurance) -$160 per session ( can involve equine therapy or in office) . 

***Substance Abuse/Dependence Intervention (Not Covered by Insurance)- Fee is done on Retainer. $300 pr/hr. (15 hrs.) Team approach is taken Counselor and Co-Counselor. Any Travel expenses covered by Client

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** Consultations to schools, physicians, other professionals, etc., will be billed at our usual hourly rate of $130.00, and may include travel time.

* Any Written Reports this includes Substance Abuse Evaluations, Letters to court, School or Court Letters are $120.00. Payment is due at the time you receive the report. 

*Missed Appointments or Late Cancellations are costly to the therapist and deny other individuals the opportunity to use that time. Unless a true emergency exists, we require that all cancellations be made at least 24 hours in advance. If you miss an appointment, or cancellations are not made in advance, you will be charged $80.00 for that session.

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* MEDICAL RECORD FEES*

*These fees are based on ORC 3701.742 and adjusted by ODH per ORC 3701.742 according to the annual consumer price index for all urban areas for the preceding year as published by the U.S. Department of Labor.


If the request is made by the patient or the patient's personal representative, total costs for copies and all services related to those copies shall not exceed the sum of the following:

With respect to data recorded on paper or electronically:
$3.25 per page for the first 10 pages,
$0.68 per page for pages 11-50
$0.27 per page for pages numbering more than 50

What may Not be included in Medical Records

*Psychotherapy Notes -  individuals also do not have a right to access the psychotherapy notes that a mental health professional maintains separately from the individual’s medical record and that document or analyze the contents of a counseling session with the individual.  In addition, individuals do not have a right to access information about the individual compiled in reasonable anticipation of, or for use in, a legal proceeding (but the individual retains the right to access the underlying PHI from the designated record set(s) about the individual used to generate the litigation information).    However, a covered entity has the discretion to share this information with the individual if it chooses.  See 45 CFR 164.524(a)(1) – (a)(3) for a complete list of exceptions to the right of access.
 

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* What may not be included in medical records

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Postage may also be charged 

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*Returned Checks -- Clients are responsible for any bank fees incurred due to returned checks. A bank service fee of $35.00 per check will be charged to the client.

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Clinical Psychological Evaluation Packages

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Emotional Support Evaluation and Letter $180

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Clinical Psychological Evaluation: $375*

Includes Clinical diagnostic interview, psychological testing, feedback session, written report. Useful for diagnosing mental disorders such as anxiety disorders, depressive disorders, bipolar disorder, psychotic disorders, and personality disorders. Involves an initial appointment for the clinical interview, possible additional appointments for testing, and 1 appointment for the feedback session, which will involve our Clinical Director.* Price may adjust if more that one test is needing to be administered or more than one day are needed for testing.

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Clinical Sex Offender Risk Assessment- Court letter: $275

Includes Clinical diagnostic interview, Risk assessment written report and feedback session. Written report can also be submitted to court or probation if needed.

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Substance abuse/ Alcohol Use/Abuse Assessment - Court letter - $275

Combined with diagnostic interview to gain insight into substance dependence disorder. Client will also receive a written report and feedback session.

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