Insurance and Fees
Invest in yourself and your relationship
Our policies, fees, and providers.
Our prices and policies
You pay for insurance and therefore you want to take advantage of the benefits afforded to you. Please review this section carefully. While we endeavor to provide up-to-date information here, you are solely responsible for understanding your benefits and the limits thereof.
Disclosure
Insurance requires that the care provided is medically necessary based on symptom severity meeting criteria for a psychiatric diagnosis. In other words, when you use your insurance, you must be given a psychiatric diagnosis. There is no exception. If your symptoms do not meet diagnostic criteria, no diagnosis will be assigned, and you will not be eligible to use your insurance.
You might think, “Well, my previous therapist/psychiatric nurse practitioner didn’t give me a diagnosis, and I used insurance.” You most definitely received a diagnosis. You simply may have not been told what diagnosis was used.
We are happy to bill your insurance for services provided for the treatment of specified psychiatric conditions. Nevertheless, please keep in mind that some psychiatric diagnosis for some insurance policies are not covered (e.g., sexual health disorders). In short, even if your symptoms meet criteria for a psychiatric diagnosis, it is not a guarantee that your insurance will cover the costs. Consequently, you will be responsible for any charges not covered by insurance.
Marriage and Couples Counseling
Insurance is not accepted for marriage or couples counseling where the goal is to decrease relationship distress, improve communication and intimacy, and address infidelity, etc.
Insurances require treatment focus on alleviating the psychiatric symptoms of an individual.
Couples Counseling and Marriage Therapy focus on improving the quality of the relationship. The “client” is the relationship, not any specific individual.
Insurance companies are solely in the business of providing coverage for medical conditions that require treatment based on the severity of symptoms. Insurance companies are not in the business of helping you with your relationship.
You might be thinking, “My prior marriage therapist billed my insurance.”
While this might have been the case, this implied that you had the problem (i.e., psychiatric condition) and that treatment focused on alleviating those symptoms.
Our experience is that the problem is in the relationship and not between any individual person’s ears. You have heard of the old saying, “It takes two to tango.” When either person has never tangoed, the dance can look like a mess. The mess, however, isn’t evidence that either individual is impaired. The mess is a normal result of this particular context (i.e., two people who don’t know how to tango).
Ultimately, we are advocates for your relationship. Insurance requires that the therapist be the advocate for the person with the diagnosis; therefore, when a provider bills insurance, the treatment agenda must be set by the patient with the diagnosis.
In-Network Insurance
Not all providers are In-Network with all plans.
Please ensure that your individual provider is in-network with your specific insurance plan. You can find this information on your insurance company’s website.
We are happy to verify your benefits and bill your insurance as a courtesy. Nevertheless, you are solely responsible for knowing your benefits and the limits of your coverage.
Out-of-Network Insurance
Have another insurance not listed above, or is your preferred provider not associated with your insurance? You might be eligible to use out-of-network benefits. We are happy to submit claims on your behalf, which will contribute to your deductible or result in reimbursement from your provider.
If you would like to inquire about Out-of-Network Benefits, we provide the following questions to ask your insurance company representative:
- What are the representative’s name and extension number?
- Are services rendered by my preferred provider covered within my Out-of-Network benefits?
- My therapist is willing to provide a statement (aka, Superbill) of Session Dates Attended, the CPT code, and the diagnosis. Is this acceptable to the insurance company?
- Does my policy cover Individual Psychotherapy (CPT code 90834). Please note, most insurances do NOT cover Couples or Marriage Counseling.
- What mental health diagnoses are NOT reimbursable?
- How many sessions are covered per year?
- What is the lifetime maximum for mental health benefits?
- What is my Out-of-Network deductible?
- What is the allowed amount of the fee?
- What percent of the allowed amount will be reimbursed?
- How do I file a claim?
NOTE: Many insurance companies will reimburse a percentage of the total fee paid. For example, your company may reimburse you 80% of the total fee paid. ($160 of the total fee of 200.) Other companies will substitute the $200 fee for what they deem appropriate, regardless of what you paid. For example, your company might say that they will reimburse you 80% of the “allowed amount of the fee.” You paid $200 for an individual session, but your insurance company only allows $100; therefore you will be reimbursed 80% of the $100, or $80. They may try to withhold this information from you and can legally do so. Ask to speak to a supervisor and convey to them that you cannot plan your medical expense budget without this number.
Fees
Private pay fees depend on the provider and specific services. Below are current rates. Rates are subject to change.
Psychotherapists
Analise Anderson, LCSW
Initial session: Couples (90 minutes): $190.00.
Initial session: Individuals (50 minutes): $125.00.
Follow-up appointments
45-50 minutes: $100.00
53-60 minutes: $120.00
90 minutes: $190.00
Late Cancellation with 24-hour advanced notice
45-60 minutes: $75.00
90-minute sessions: $100.00
No show fee
Fee is equal to the amount for the missed session.
Extended Service fee (When sessions exceed permissible length of time)
40-45-minute $100
15-minute increments: $20
In-Network Provider
- BCBS (Most plans)
- United/Optum
- MEDCOST
- CBHA
- AETNA
- CIGNA
- Medicare
Randy Garcia, LMFT (PR), LCMHCA (NC)
Initial session: Couples (90 minutes): $190.00.
Initial session: Individuals (50 minutes): $125.00.
Follow-up appointments
45-50 minutes: $100.00
53-60 minutes: $120.00
90 minutes: $190.00
Late Cancellation with 24-hour advanced notice
45-60 minutes: $75.00
90-minute sessions: $100.00
No show fee
Fee is equal to the amount for the missed session.
Extended Service fee (When sessions exceed permissible length of time)
40-45-minute $100
15-minute increments: $20
In-Network Provider
- BCBS (Most plans)
- MEDCOST
- CBHA
- AETNA
DR. Tom Murray, LMFT, LCMHCS
SEX THERAPY AND COUPLES COUNSELING
Initial Appointment
55 minutes $195
90 minutes $310
Follow-up Appointments
45-50 minutes: $155.00
53-60 minutes: $190.00
75 minutes: $260
90 minutes: $310.00
DISCERNMENT COUNSELING for Couples on the Brink
First Session (2 hours) – $350
Follow-up Sessions #2-5 (90 minutes) – $250
Late Cancellation with 24-hour advanced notice
45-60 minutes: $100.00
90-minute sessions: $150.00
No show fee
Fee is equal to the amount for the missed session.
Cancellation Policy
Cancellation Policy: We will charge a late cancellation fee if you do not cancel within 48 hours’ notice or no show fee, as stated in our policies. If forms are not completed within 48-hours of the appointment, we will cancel the appointment.
Paperwork: Please fill out and sign all the client intake forms, including the payment information document, before your first appointment with us. We require all clients to leave a credit card, debit card on file at the time of scheduling. We will charge a late cancellation fee if you do not cancel within 48 hours’ notice or no show fee, as stated in our policies. If you do not receive an email invitation to complete the forms, please contact the office as soon as possible. If forms are not completed within 48-hours of the appointment, we will cancel the appointment.
