The out-of-pocket fee for an initial evaluation session is $210.00. The fee for subsequent routine 45-minute psychotherapy sessions is $150.00. Cancelations with less than 24 hours notice (unless due to an emergency, such as an unanticipated extreme weather event, a sudden life-threatening health problem, a death in the family, etc.) incur the regular full fee charge (i.e., the out-of-pocket fee or the total amount that you and your insurance would have reimbursed for the session). If your insurance covers our sessions, you are responsible for the co-pay, co-insurance, and deductible charges. Due to contract limitations, I am not able to bill insurance if we do not have a session.
Insurance and Private Pay
I am an in-network provider for some of the behavioral health/mental health service plans with Aetna and Blue Cross Blue Shield. I'm considered out-of-network with all other health care plans. You are responsible for all co-pays, co-insurance, and meeting your deductible (if applicable). If you're hoping to use insurance to cover our sessions, I encourage you educate yourself about what your particular plan covers (and what it doesn't) because payment for the sessions are ulimately your responsibility. You have the right to a “Good Faith Estimate” to help estimate the expected charges you may be billed for receiving certain health care items and services.
I also offer private pay counseling and psychotherapy, which means that I do not bill an insurance company and instead am paid directly by the client. Some people choose to pay out of pocket because they like to feel that they want to know that no personal information will be disclosed to any third party (such as a health insurance company that authorizes services related to mental health or substance abuse, an insurance company that offers disability or life insurance coverage, etc.). Others have decided to meet with me even when they have insurance coverage (though it may not cover our meetings due to my being out-of-network) because they feel that the therapeutic connection is so positive and important, and they find a high "goodness-of-fit" with me. I've been told by current (and former clients) who pay out of pocket that they feel especially empowered in our sessions because they are making a real investment in themselves, and as such, take more ownership in the therapy process.
Getting Coverage for Out-of-Network Providers
If you intend to pay out of pocket, it may be worthwhile to explore whether your insurance plan offers out-of-network benefits that would cover a percentage of my fee. If you'd like to find out whether your insurance company would reimburse you for the cost of counseling/therapy with me, I encourage you to contact your insurance company. Questions that you might ask your insurance company include:
Do I have out-of-network benefits to see a licensed psychologist?
If so, what percentage do you cover?
What is the deductible, and how much of the deductible have I met?
What is my co-pay for a session if I see an out-of-network provider?
How many sessions are covered, and in what time period?
How do I access the form(s) needed to submit a request for reimbursement?
If you find that you have out-of-network benefits, I ask that you pay me directly (see above for my fees), and I will provide you with a receipt which you can submit to your insurance company for reimbursement.
The Massachusetts Psychological Association (MPA) has provided some suggestions for getting mental health coverage for out-of-network providers through your managed care network. For example, MPA recommends requesting an out-of-network authorization from your managed care network; contacting the Bureau of Managed Care; and contacting the Human Resources Department at your employer who is providing the health coverage.
Katharine C. Townsend, Ph.D.
8 Harris St., Newburyport, MA 01950 • 978-499-9080