Who will I see for services at The Heart of the Matter?
How much will services cost?
The cost will vary depending on which therapist you see. Most services cost between $160 and $240, depending on the therapist and type of session. There are some sliding scale opportunities for each therapist.
Can I use my insurance?
Depending on the service and insurance company, you may be able to use your insurance. Most insurance plans do NOT pay for Couples Counseling without a diagnosis impacting the relationship. Check with your insurance or we will have our Intake Coordinator check for you. We are in-network with CIGNA and Aetna for individual therapy. However, we do not take in-network insurance for couples counseling. If we are not in network with your insurance and you have a PPO, we will provide you with a “Super Bill” to submit to your insurance company. We are also able to submit “Courtesy Claims” on your behalf for Blue Cross/Blue Shield PPOs.
Can I use my HSA or FSA card?
What if I don't click with the therapist I am matched with?
If you find you aren’t fitting well with the therapist you have been matched with, please feel free to reconnect with our Intake Coordinator and she will help you find a therapist that would work well for you.
I’m concerned that therapy will be difficult for me/us.
I worry about going too fast and becoming overwhelmed.
I want to work through some traumatic events that happened to me, but I don’t want to share all the details. Is that possible?
The No Surprises Act and Good Faith Estimates
What is the No Surprises Act?
Beginning January 1, 2022, the No Surprises Act (H.R. 133) will go into effect. The law includes new requirements for health care providers, facilities, health plans and insurers which are intended to prevent consumers (a.k.a. patients) from receiving unanticipated medical bills. The No Surprises Act resulted in changes to the Public Health Service Act that also apply to health care providers and facilities.
Part I of the regulations protects consumers with health plan coverage from surprise bills from out-of-network providers under limited circumstances related to emergency and non-emergency services at in-network facilities.
Part II of the no surprise billing regulations, published in October of 2021, requires all health care providers and health care facilities licensed, certified or approved by the state to provide good faith estimates of expected charges for services and items offered to uninsured and self-pay consumers.
Timeframes for Providing Good Faith Estimates
Providers and facilities must meet the following deadlines for providing good faith estimates:
If the item or service is scheduled at least 10 business days in advance, the good faith estimate must be provided within three business days.
If the item or service is scheduled at least three business days in advance, the good faith estimate must be provided within one business day.
If the individual requests such information, the good faith estimate must be provided within three business days.
Note: No estimate is required if a service is scheduled less than three business days before the appointment.
What You Will Receive
You will receive a written Good Faith Estimate (GFE) that includes an estimate of services (type of therapy/estimate of frequency) and estimated costs for those services for a 12 month period.
Psychotherapy is unique in that it is not possible to predict how your personal therapeutic process will unfold until we get started; there are many factors that contribute to this and every person is unique and different. The following is information that will help you anticipate and plan the cost of your therapy.
All services at The Heart of the Matter Relationship Counseling are billable except scheduling communication and 15 minute consultations.
The billable full fee rate for services is $220 for the intake session and $170 per 50 minute session. Sessions exceeding 60 minutes are billed at a prorated fee in 15 minute increments. Sessions may be scheduled for more or less time than a standard 50 minute session and are billable in 15 minute increments. No-shows and late cancellations are billable at the full fee.
You can calculate an estimate on your own by multiplying the billable rate of $170 by the number of sessions you anticipate wanting/needing, plus the intake session. The industry standard is weekly therapy however at times clients require/request multiple sessions in a week. Conversely, clients may titrate down to less than weekly sessions also.
At times, additional services are requested/required, for example in times of stress or emergency, high conflict scheduling issues, collaboration with other professionals, or collaboration with other family members.
Therapists at The Heart of the Matter Relationship Counseling do not appear in court. The Fees for court appearances and preparation for court, if subpoenaed, are higher than our standard rate.
Here are some potential monthly/annual costs for therapy excluding the intake session and any additional services listed above (based on a 5 week month).
Weekly therapy: $850 per mo. $10,200 per year
Bi-weekly services: $425 per mo. $5,100 per year
Once monthly service: $170 per mo. $2,040 per year
Superbills and CPT Billing Codes
Some clients utilize superbills to help reduce the cost of out of pocket therapy. A superbill is a detailed receipt that includes a diagnosis and billing codes. The billing codes most often used at The Heart of the Matter Relationship Counseling are (though not limited to):
90791 – Psychiatric diagnostic evaluation
90837 – Individual therapy
90847 – Couples/Family therapy with the client present 50 minutes
90846 – Couples/Family therapy without client present 50 minutes
You may call your health insurance provider and inquire if they will reimburse a superbill, and if so, at what rate. This may help with your financial planning. When using a superbill, you pay for therapy at the time of service and submit a superbill to your insurance provider for reimbursement.
You Have the Right to Dispute Your Charges
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
For questions, or more information about your right to a Good Faith Estimate, visit www.cms.gove/nosurprises.