- Avg Cost (per session): $150 (60 min) $250 (90 min)
- Phone counseling or counseling by email is also available. These services are not covered under insurance and must be prepaid and pre-scheduled: $150 (60 min) $250 (90 min).
- Substance Misuse Evaluations: $225
- Individual Education and Prevention Substance Misuse Sessions in a private practice setting are discounted to $130 per session when purchased in advance: (6) sessions $780 (12) sessions: $ 1,560. Fee includes all documentation necessary for legal purposes upon admission, during your progress, and discharge. Drug testing is not available at this location.
- Sliding Scale: Available upon request with proof of income at or under the poverty line amount (1 person-$11,880; 2 persons-$16.020; 3 persons-$20,160; 4 persons-$24,300)
- Accepted Payment Methods: American Express, Cash, Check, Mastercard, Visa
Accepted Insurance Plans
- BlueCross and BlueShield
- If you do not see your insurance carrier listed, please contact your agency and ask whether you have Out of Network benefits. We will be happy to give you a receipt to turn into your insurance company for possible reimbursement.
Please attempt to verify your health insurance coverage when you arrange your first visit. This can be done by calling the Behavioral Health number on the back of your card. See our “ Should I use my insurance? ” section for types of questions you should ask your insurance carrier. We will also be happy to help you with this verification process.
A question I often get is: “Should I use my health insurance to pay for individual counseling or couples counseling?” I always encourage potential and existing clients to investigate all options and to do their research with their State’s Medical Records Privacy statutes. This way you can make an informed decision BEFORE you use your benefits. With the new affordable care act many people are excited to finally have coverage and use their benefits. Here are some of the most common questions and risks of using your health insurance for counseling:
1. Is there a requirement of a diagnosis for mental illness or substance misuse?
Insurance companies only pay for treatment that is “medically necessary.” This means you have to have an approvable diagnosis that is impacting your ability to function on a day to day basis. Many problems in life are not a mental health disorder, nor do they meet the criteria for a diagnosis, therefore leaving a possibility of your claim getting denied or the provider diagnosing you with “light” diagnosis, such as Adjustment Disorder to meet the medical necessary requirement for you to be covered. Do you really want a diagnosis code in your file if you do not need one?
Secondly, your insurance company will advise you and your provider that “a quote for benefits does not guarantee coverage or payment.” This means you can be told over the phone you have coverage and be denied once they review the diagnosis code. If the claim is denied for this reason, you are responsible for payment.
2. What about couples counseling?
Couples Counseling is not covered by any of the major insurance companies. As unbelievable as it is, Insurance companies do not view marital problems as a medically necessary reason for them to pay for your therapy. Therefore, this service will be offered as a self-pay service.
If you or your significant other already have a mental health or substance misuse diagnosis and the marital problems are complicating it, we may then be able to bill your insurance for a few family sessions. Please contact our office if you have any questions.
3. Who gets my information? For a detailed review of the Florida statues, please go to: http://www.floridahealth.gov/about-the-department-of-health/about-us/patient-rights-and-safety/hipaa/index.html
Anything that is part of your file becomes a permanent part of your file. You are unable to remove information out of your file once it is there. You do have a right to look at your file and add an addendum to anything you feel is inaccurate. This can be devastating for some. This includes your diagnosis, treatment plans, progress notes, etc…This may mean that when you apply for new health insurance, life insurance and many types of employment, they can require an authorization to release information in your medical record. You also have the right to not authorize the release of this information in certain circumstances. With the new affordable care act, pre-existing conditions are less of an issue; however insurance companies can charge you a higher premium for having been treated with a prior diagnosis.
4. Are there limitations to my policy? With many plans and the affordable care act, there are numerous companies and plans out there. Numerous Insurance companies have merged several times, benefits are constantly changing and most insureds are never even notified. Policies typically have high deductibles and co-payments or coinsurance. This means you will have to self-pay out of pocket anyway until your deductible has been met. Once your deductible is met, some plans pay 100%; others still charge you a portion or percentage of the bill called a co-payment of co-insurance. Many plans limit the number of sessions you can see your counselor, as well as they limit the amount of time you can see your counselor. Most plans only pay for a 45 minute session. If you need a 60 minute session or a longer crisis session, this must be pre-authorization in order to be paid. It should be up to the counselor and the client how long of a session is needed and how many sessions are needed. Many plans also limit the milligrams or types of medication you are approved for. Many plans also do not give you a choice of which counselor you can see, you have to pick one on their list. Insurance plans also do not cover missed appointment fees or phone sessions.
5. What are my options? What can I do? As stated earlier, DO YOUR RESEARCH! Unfortunately navigating the insurance world is a complicated and confusing process. Even those of us that work daily with insurance find it overwhelming and frustrating at times to get a straight answer or even anyone on the phone! Call your Insurance Company and ask these important questions: Do I have a deductible? Do I have a co-pay? Do I have co-insurance? Are my sessions limited? Are my session times limited? Can I go to a provider of my choice? Are my current medications and doses covered? Is my current counselor or counselor you picked out in your network? Do I have out of network benefits and what are they (if your counselor or choice of counselor is not in network). If your counselor does not accept insurance or is not in network with your plan, you will self-pay up front and the counselor will give you a receipt to send in to your Insurance Company to see if you are eligible for any type of reimbursement.
Due to the complexity and uncertainty of coverage, the importance of my clients having a right to see which ever Dr. or counselor they choose, how often they see their counselor, how long their sessions are, their not wanting a diagnosis in their file, and their choice to place a high value on their privacy and their relationship’s privacy, most of my clients select to not use their insurance for counseling purposes.