Billing Policies
Please note
Payments: We accept HSA and FSA, as well as all major credit and debit cards.
Insurance: We are not under contract (“in-network”) with any insurance companies, but we will provide you with a statement for insurance reimbursement (sometimes called a “superbill”) that you can use to seek reimbursement from your insurance company on an out-of-network basis. Learn more here.
The Reasons Behind Our Billing Policies
You can click on the frequently asked questions below to learn more about the reasons behind our billing policies:
-
We believe that the most effective mental health care happens when the relationship between the provider and the patient is at the very heart of the process. It's about building trust, fostering open communication, and crafting a treatment plan that's as unique as you are.
To ensure we can dedicate our full attention to this personalized, patient-centered approach, we operate as an out-of-network provider. What does that mean for you? It means we work directly for you, not for an insurance company.
Insurance, while helpful in many healthcare areas, can sometimes create limitations in mental healthcare. Insurance companies often dictate:
The number of sessions you're "allowed": Your healing journey isn't one-size-fits-all. We believe you and your provider should decide together how long therapy should last, based on your needs and progress, not an arbitrary number set by a third party.
The length of sessions you’re “allowed”: Insurance companies often refuse to pay for sessions longer than 45 minutes, which we find to be an inadequate amount of time for the majority of our patients. Instead, our standard psychotherapy sessions are a full 60 minutes, which makes a deeper and more impactful therapeutic conversation possible.
The type of therapy you can receive: We utilize a range of evidence-based therapeutic approaches, tailoring our methods to fit your specific challenges and goals. Insurance companies may only cover certain modalities, limiting your options and potentially hindering your progress.
Diagnosis Requirements: Insurance companies almost always require a formal diagnosis to cover therapy. We believe in treating the person, not just a label. While a diagnosis can be helpful for some, it shouldn't be a prerequisite for receiving support, and it may not always accurately reflect your experience. Your privacy is important and a diagnosis becomes a permanent part of your medical records.
Confidentiality Concerns: When using insurance, detailed session notes and personal information are often required to be shared with the insurance company for billing purposes. While those notes are supposed to be kept confidential, they are no longer completely under the control of the client or practice.
By working directly with you, we eliminate these potential hurdles. We can:
Focus entirely on your needs: Our time and energy are dedicated to providing you with the best possible care, without the administrative burden of insurance paperwork and pre-approvals.
Offer truly customized treatment: We're free to collaborate with you on a plan that fits your life and your therapeutic goals, without external constraints dictated by a corporate third-party.
Maintain the highest level of privacy and confidentiality: Your information stays between you and your provider, ensuring a safe and trusted therapeutic environment. Insurance companies sometimes have large data breaches, and we’re committed to keeping your confidential mental health treatment information (including your therapist’s notes) off of the dark web.
We understand that the cost of therapy is a significant consideration. We're happy to provide you with a "superbill", a detailed receipt, that you can submit to your insurance company for potential out-of-network reimbursement. Many of our clients find that they receive substantial reimbursement, making the investment in their well-being more manageable. We encourage you to contact your insurance provider directly to understand your out-of-network benefits.
Ultimately, choosing a therapist is a deeply personal decision. We believe it should be based on connection, trust, and a shared commitment to your well-being. We invite you to schedule a first session to learn more about our approach and see if we're the right fit for you.
See also:
NPR recently published an excellent article explaining why therapists are leaving health insurance networks and our colleague from Boston also explains the reasons in-depth in this excellent blog post.
-
We believe that the highest quality psychiatric care comes from a flexible and responsive relationship that is able to meet your needs as they are, rather than as they fit into a rigid fee-for-service model. It is vital that when you need support, you are able to access it as quickly as possible, with the focus and attention your situation demands, without having to worry about additional costs.
Our billing model allows us to offer a more responsive and flexible level of care, designed to fit seamlessly into your life.
Care That Fits Your Schedule: Asynchronous Communication
We recognize that scheduling frequent in-person appointments can be challenging. Our billing model supports extensive asynchronous care. This means you can communicate with your psychiatrist between appointments through secure messaging (e.g., via our patient portal) for questions about your medication, side effects, or adjustments - and can expect a timely and thoughtful response. This is ideal for busy professionals and individuals who may not always have time for a full appointment but need timely advice. Traditional fee-for-service-only models often disincentivize this type of ongoing communication, as each interaction would typically incur a separate charge. Our model allows for continuous support, making it easier to optimize your treatment.
Shorter Wait Times for Appointments When You Need Them
Because so much of your care can be delivered asynchronously (addressing many concerns without requiring a full appointment), we have significantly more availability for in-person or virtual follow-up appointments when they are needed. This means shorter wait times for urgent issues or when a more in-depth discussion is necessary. You won't face long delays to see your psychiatrist when you need support.
More Time, More Personalized Attention
Our billing model allows our psychiatrists to dedicate more time to each patient. We schedule only two follow-up appointments per hour, a stark contrast to the industry standard of four or more, and we never double-book. This means your psychiatrist has ample time to:
Thoroughly review your progress and concerns.
Answer your questions in detail.
Collaboratively adjust your treatment plan as needed.
Provide education and support, not just a prescription.
You'll receive focused, unhurried care, ensuring your needs are fully addressed.
Removing Financial Disincentives Related to Scheduling
Perhaps most importantly, our monthly/quarterly fee removes the financial disincentive to seek help. You can contact your psychiatrist as often as needed, through secure messaging or by scheduling follow-up appointments, without worrying about accumulating significant additional charges. Your mental health is the priority, and this model ensures that cost doesn't prevent our patients from receiving the support they deserve. This fosters a stronger patient-provider relationship and allows for proactive management of your mental health.
Our billing model allows us to provide a more responsive, accessible, and personalized approach to psychiatric medication management. It's designed to provide the best possible care in a way that respects your time and promotes consistent well-being.
We are happy to answer any questions you may have about our billing model. Please don't hesitate to reach out to our office.
-
We understand that investing in your mental health is a significant decision. We also recognize that our fees are higher than some other practices in the Seattle area. We want to be completely transparent about why this is the case, and more importantly, how our fee structure directly translates into a higher standard of care for you. We believe that understanding the "why" behind our pricing is crucial for building trust and ensuring you feel confident in your choice to work with us.
The Value of Effective Care
It's tempting to focus solely on the cost of a single session. However, the true measure of value in mental healthcare isn't just the price per session, but the overall effectiveness of your treatment. Here are two key principles we operate on:
Faster, More Focused Treatment: Our approach is designed to be highly effective. We invest heavily in strategies and training that allow our providers to get to the root of issues quickly and efficiently. This often means that while individual sessions may cost more, the total number of sessions you need (and therefore your total cost) may be significantly less than at a practice with lower hourly rates but a longer, less focused approach.
Longer, More Meaningful Sessions: We offer 60-minute therapy sessions, compared to the standard 45-minute sessions at many other practices. This additional time allows for deeper exploration of issues, more thorough processing, and a greater sense of connection with your provider. When you compare our fees on a per-minute basis, the difference is far less significant, and the added value of that extra time is immeasurable.
Attracting and Retaining Great Providers
Our commitment to providing exceptional care starts with our team. Our fee structure allows us to:
Attract Excellent Providers: We compete nationally to recruit exceptional psychologists, psychiatrists, and psychotherapists. We aim to hire highly sought-after professionals with extensive training, experience, and a proven track record of success. We offer competitive compensation and benefits to ensure we can bring these providers to Seattle and to our clinic.
Empower Our Providers to Thrive: We believe that a well-supported provider is a better provider. Our fees allow us to create a working environment that prioritizes their well-being. This includes:
Reduced Burnout: We provide manageable caseloads, administrative support, and ongoing professional development opportunities. This reduces burnout and allows our providers to be fully present and engaged with each patient.
Time for Deep Work: We make it possible for our providers to take a break between each of their sessions. They have the time and space to thoroughly prepare for sessions, reflect on your progress, consult relevant empirical literature, and collaborate with colleagues when necessary.
Continuous Growth: We invest heavily in continuing education, ensuring our team stays at the forefront of the latest research and best practices.
Expanding Access to Care in Seattle: By offering compelling compensation packages, we're able to attract experienced mental health professionals from out of state, directly addressing the shortage of qualified providers in our region. This is a long-term investment in the overall well-being of our community.
Setting and Support
We believe that the environment in which you receive care, and the logistics of that care, play a vital role in your healing journey. Our fees allow us to invest in providing care that is:
Welcoming and Serene: Our offices, located in a beautiful historic building in downtown Seattle, are designed to be calming and restorative. We've invested in comfortable furnishings, art, live plants, and thoughtful details to create a space where you can feel safe, relaxed, and supported.
Responsive and Convenient: We have dedicated administrative staff to handle scheduling, billing, medical records requests, and all other aspects of office management, allowing our providers to focus on your care. This also means:
Rapid Intake: We understand that when you're seeking help, you need to receive care in a timely manner. We strive to offer (and are often able to provide) intake appointments within days, not weeks or months, a rarity in the current mental health landscape.
No Wait-list: Because our approach often leads to shorter, more effective treatment plans, we rarely have a waitlist. This prevents patients from lingering in therapy longer than necessary (which can sometimes hinder progress) and ensures that we have openings for those who need immediate support.
Secure: We utilize some of the most secure and reliable technology and security practices to manage patient information and protect that information from data breaches.
Not Profit Driven: We work to maintain a low (single digit) profit margin to ensure the financial stability of the practice, and all profits go to practitioners working in the practice, not outside investors. This allows us to foster an environment in which excellent care is delivered by providers who love their jobs and are well taken care of.
A Partnership in Your Journey
Ultimately, we see our relationship with you as a partnership. We're committed to providing the highest possible standard of care, and our fees are a direct reflection of that commitment. We believe that investing in your mental health is one of the most important investments you can make, and we're honored to be a part of your journey.
Individual Psychotherapy & Counseling
| Service | Cost |
When Charged |
|---|---|---|
| Individual Therapy Intake Session / Follow-up session | $275 | Day of session |
$275 per 60 minute individual therapy or relationship counseling session.
Cancellation Policy: at least 24 hours notice for all individual psychotherapy or counseling appointments, or they will be billed in full, see here for more info.
Relationship Counseling
| Service | Cost |
When Charged |
|---|---|---|
| Relationship Counseling Intake Session / Follow-up session | $275 | Day of session |
$275 per 60 minute relationship counseling session.
Cancellation Policy: at least 24 hours notice for all relationship counseling appointments, or they will be billed in full, see here for more info.
Group Psychotherapy & Counseling
| Service | Cost |
When Charged |
|---|---|---|
| 90-minute Group Session | $90 | Day of session |
$75 for a one-time 25-minute pre-screening assessment (can be conducted digitally or in-person).
$90 per 90-minute session.
If you wish to seek reimbursement from your insurance company, you’ll need to receive a diagnosis. You may provide paperwork that establishes diagnosis from another provider (e.g., a psychiatrist, psychologist, or other mental health provider you have seen) or you may schedule a 60-minute, one on one, psychiatric diagnostic evaluation, where we can determine whether and which diagnosis is appropriate. Scheduling a diagnostic evaluation is optional, would need to be scheduled separately, and would be billed at $275.
Cancellation Policy: weekly payments for groups and classes are only waived when a session is cancelled by the therapist leading the group/class. Although notifying your therapist that you cannot make it to a group/class session is very much appreciated, you will still be billed the weekly fee until you terminate your membership in the group/class.
Psychiatric Medication (Intake & Ongoing Management)
| Service | Cost |
When Charged |
|---|---|---|
| Intake Session | $575 | Day of session |
| First month of being a patient under the doctor's care * | $275, but your fee will be waived if you elect to become a current patient within 60 days of your intake appointment with the psychiatrist. | At the beginning of the billing period. |
| Recurring fee to be a current patient under the doctor's care * | The cost is about $275 per month billed either monthly or quarterly, depending on option chosen ** | Monthly or quarterly at beginning of billing period *** |
$575 for initial 60 minute intake appointment. This initial appointment includes a thorough diagnostic assessment to help your psychiatrist understand your symptoms, medical history, and lifestyle goals. Based on this assessment, you and your psychiatrist will also discuss whether medications or other supplements could be helpful for you and what the best options would be.
If you decide to become a patient of one of our psychiatrists (e.g., by getting a prescription from them, scheduling a follow-up appointment with them, etc.), you’ll have the choice of either our Monthly Med-Management Billing Option or our Quarterly Med-Management Billing Option, which is billed each month/quarter until services are cancelled.
Monthly Med-Management Billing Option
You’ll pay a $275 monthly administrative fee to be a current patient.
Your first month’s administrative fee will be waived if you elect to be a current patient within 60 days of your intake appointment with the psychiatrist.
Current patients pay just $1 for each of their follow up appointments.
Statements for insurance reimbursement will be provided on a monthly basis.
Quarterly Med-Management Billing Option
Note that the quarterly billing option may be preferable for patients intending to seek reimbursement from their insurance company. This is because some insurance companies are unwilling to provide reimbursement for administrative fees, but many are willing to reimburse a portion of costs for appointment fees.
You’ll be charged $825 on a quarterly basis to be a current patient.
If you qualify for a free first month by electing to be a current patient within 60 days of your intake appointment with the psychiatrist, your first quarterly fee will be charged one month after you elect to be a current patient.
The amount you’ll pay for the quarterly administrative fee and for your follow up appointments will depend on how many follow up appointments you have that quarter, but you’ll never be billed more than $825 for medication management services per quarter (not including intake fees).
If you have 0 follow up appointments during the quarter you’ll pay $825 for the quarterly administrative fee.
If you have any follow up appointments during the quarter, you’ll instead pay $0 for the quarterly administrative fee.
If you have 1 follow up appointment during the quarter, you’ll pay $825 per follow up appointment that quarter.
If you have 2 follow up appointments during the quarter, you’ll pay $412.50 for each follow up appointment that quarter.
If you have 3 follow up appointments during the quarter, you’ll pay $275 for each follow up appointment that quarter.
If you have 4 or more follow up appointments during a single quarter, you’ll pay $275 for the first 3 follow up appointments and $0 for any additional follow up appointments during that quarter.
Statements for insurance reimbursement will be provided on a quarterly basis, shortly after each quarter concludes.
Cancellation and refund policy:
At least 24 hours notice of cancellation for intake and follow-up appointments, or you will be billed in full. No refunds are allowed for appointment fees, including the initial intake session, under any circumstances.
By signing up for this service, you agree to automatically recurring monthly or quarterly fees (depending on option chosen). It will be your responsibility to contact us to cancel the recurring fee by requesting to be removed from under your doctor's care.
For the Monthly Med-Management Billing Option, no refunds will be given for the monthly fee past 5 days from the start of the fee's billing period.
For the Quarterly Med-Management Billing Option, if you terminate services before the 30th day of the quarterly billing period, you will be eligible for a $550 refund, if you terminate services before the 60th day of the quarterly billing period, you will be eligible for a $275 refund, and if you terminate services on or after the 60th day of the quarterly billing period, no refund will be given.
See here for more info.
*Note for those seeking insurance reimbursement:
The administrative fees (monthly and quarterly) do not have a CPT/procedure code per the American Medical Association. We have been told by our clients that many of their insurance providers say they will not reimburse without a CPT/procedure code, so we suggest checking in with your insurance provider first if you will be seeking reimbursement for that fee.
It is for this reason why we created the quarterly billing option, as it puts the costs on the session(s) had during the quarter which have CPT/procedure codes. Please reach out to your insurance provider to learn about your allowed amounts and your particular plan’s out of network benefits.
Psychological Testing/Assessments
| Description | Cost |
When Charged |
|---|---|---|
| Testing | Usually range between $2,500 - $5,000 | Day of session |
Note that most patients do not require any psychological testing. This is usually done because a school, employer, or other institution is requiring testing for an accommodation. However, we occasionally need to do testing when mental health issues are especially complex.
Price usually ranges being between $2,500-$5,000
*Please note: The total cost of each testing service includes diagnostic interview, administration and scoring of each instrument used, cost of testing material, report, and feedback session. The length and duration of the testing service is determined by the objective of the testing. Testing often involves the use of additional instruments to answer the referring question. Therefore, it is impossible for your psychologist to provide you with an exact estimate for the cost of services. However, your psychologist can provide a range that encompasses most scenarios for psychological testing. At the low end of the range are patients seeking psychological testing for ADHD-related concerns. For those patients, their total cost would be $2,500. At the high end of the range are patients undergoing a full cognitive, personality and neuropsychological battery. For those patients, their total cost can be up to $8,000. There will be no “surprise” testing sessions. We will always communicate clearly about it with you in person, via phone, via email, or some other means before scheduling a single or multiple psychological testing session for you.
Insurance
We are not under contract (“in-network”) with any insurance companies, but we will provide you with a statement for insurance reimbursement (sometimes called a “superbill”) that you can use to seek reimbursement from your insurance company on an out-of-network basis.
You can learn more about our reasons for distancing ourselves from insurance company influence by clicking here.
If you decide to seek reimbursement from your insurance company, we will provide you with a detailed invoice (insurance companies call these a "superbill") that will facilitate this process. It usually only takes a couple of minutes to submit a claim and your insurance company's claims person can walk you through what steps to take if you have any questions.
Keep in mind that it is your responsibility to learn about your particular insurance plan and about what portion of our services they will cover.
It is a good idea to call your insurance company if you have any questions about your insurance plan. The number for your insurance company should be listed on your insurance card.
Some insurance companies have very particular rules and complicated reimbursement structures, so you may want to ask about your deductible, about the allowed amounts, about which services they will cover, and if there are any restrictions on which kinds of providers you can see.
If you do reach out to your insurance provider, to help you ask about your particular plan’s benefits available to you, here are the most common procedure/CPT codes used:
For individual psychotherapy & counseling, the intake session is 90791 and then is usually coded as 90837 for each follow-up session after that.
For psychiatric medication management, the intake session is 90792 and then is usually coded as 99214 for each follow-up session after that. Note that there is no procedure code for the monthly fee or quarterly fee.
If you don’t see your particular situation here, please feel free to reach out to our office.
HSA and FSA
Health savings accounts (HSA) and flexible spending accounts (FSA) can be used to pay for medical expenses such as therapy and can often significantly decrease the cost of treatment. Please feel free to use either of these as your means of payment if you have them as a medical benefit through your employer.
PAYMENTS
We accept payment via credit, debit, FSA, or HSA card.
Payment for an appointment is due the day of the appointment and is charged automatically to the card on file.
Taxes
Healthcare services are not taxed in WA State, so you will not have to pay any tax on top of what you pay for therapy and psychiatric care.
Medical expenses, including out-of-pocket costs for psychotherapy, can sometimes be deducted on your income taxes. You should speak with an accounting professional to determine whether you would be eligible for such a deduction.