Transparent fees, and honest guidance on reimbursement
This is a private, out-of-network practice. That has real trade-offs, and you deserve to understand them clearly before you book — including how to find out what your plan may reimburse.
Why this practice is out-of-network
Insurance reimbursement for psychiatry is built around brief, frequent appointments. A practice that depends on it must see many patients per day, which is precisely what prevents the kind of care described elsewhere on this site — hour-long evaluations, unhurried follow-ups, direct physician access, and coordination with the rest of your care team.
Operating outside insurance networks is what makes those things structurally possible. It also means a higher out-of-pocket cost, and for many patients that is a genuine barrier. If cost is prohibitive, say so during your inquiry call — you will receive referrals to in-network psychiatrists and community resources rather than a sales pitch.
Current fees
Appointments
- Initial psychiatric evaluation (60–90 minutes) — [ $ add fee ]
- Follow-up appointment (25–30 minutes) — [ $ add fee ]
- Extended follow-up (45–50 minutes) — [ $ add fee ]
- Parent guidance session (45 minutes) — [ $ add fee ]
- Brief phone or portal check-in — [ $ add fee or “included” ]
Other Services
- School, employer, or disability letters and forms — [ $ add fee ]
- Record review or clinician collaboration beyond routine coordination — [ $ add hourly fee ]
- Missed appointment or cancellation with less than [ 48 ] hours’ notice — [ full fee / $ amount ]
How to check what your plan will reimburse
Many PPO plans reimburse a meaningful portion of out-of-network psychiatric care once the out-of-network deductible is met. HMO and most Medi-Cal plans typically do not. Fifteen minutes on the phone with your insurer before your first appointment will tell you where you stand.
Call the member services number on the back of your insurance card and ask exactly this:
- Do I have out-of-network outpatient mental health benefits?
- What is my out-of-network deductible, and how much of it have I met this year?
- Once the deductible is met, what percentage of the allowed amount is reimbursed?
- What is the allowed amount for CPT codes 90792 (initial psychiatric evaluation) and 99215 (extended follow-up)?
The fourth question is the one most patients skip, and it matters most — insurers reimburse a percentage of their allowed amount, not of the fee you actually paid.
Read the full guide to superbillsGood Faith Estimate — No Surprises Act
Under federal law, you have the right to receive a Good Faith Estimate explaining how much your medical care will cost if you are uninsured or choose not to use insurance.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services, including psychiatric care.
- Make sure your provider gives you a Good Faith Estimate in writing at least one business day before your appointment. You may also ask for one before scheduling.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute it.
- Keep a copy of your Good Faith Estimate in a safe place.
For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-985-3059.
Fees & insurance FAQ
The practice is out-of-network with all insurance plans and does not bill insurance directly. Payment is due at the time of service. Patients with PPO plans that include out-of-network mental health benefits are provided a monthly superbill to submit to their insurer for possible partial reimbursement.
A superbill is an itemized receipt containing the diagnosis and procedure codes your insurance company needs to process an out-of-network claim. You submit it to your insurer directly, and any reimbursement is paid to you rather than to the practice.
Call the member services number on your insurance card and ask three questions: Do I have out-of-network outpatient mental health benefits? What is my out-of-network deductible, and how much of it have I met? Once the deductible is met, what percentage of the allowed amount is reimbursed for CPT codes 90792 and 99215?
Yes. Psychiatric care is a qualified medical expense, so health savings account and flexible spending account funds may generally be used.
Insurance reimbursement rates assume short, high-volume appointments. Operating outside those constraints is what makes extended evaluations, a limited caseload, and direct physician access possible.
Yes. Under the federal No Surprises Act, patients who are uninsured or who choose not to use insurance are entitled to a Good Faith Estimate of expected charges before scheduled care. The office provides this in writing.
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