|Diagnostic & Evaluation Session (1st Visit)||$199.00|
|Regular Office Visits (Individuals, Couples & Play Therapy)||$128.00|
|Family Sessions (90 Minutes)||$191.00|
|Family Sessions (60 Minutes)||$155.00|
|Court Appearance Fee||$160.00/Hr|
|Phone Consultation||$50 for 30 Min|
|Urine Drug Screens for Substance Abuse Clients||$30.00|
|Sex Offenders Risk Assessment Evaluation||$525.00|
|*Mental Health Evaluation for Court/Lawyer||$250.00|
|*Substance Abuse Evaluation||$150.00|
|*Outside office work (Inpatient visits, collaborative law services||$100/Hr|
|Written reports (courts, supervisors, pro-rated)||$100/Hr|
|Returned check fee - per check||$50|
|No Show Fee - Including appointments cancelled within a 48 hour window prior to the appt.||$60|
*Indicates those services/fees which are note covered by insurance and will be paid by client at time of service.
**Please note your account is subject to a 1.5% interest per month or 18% interest per year as well as collection fees incurred in the recouping process (to include court costs and/or attorney fees of %33 or $30 - whichever is greater).
***A reasonable fee will be charged for copies of any records requested by clients or representatives of the client (pending release of information from client).
Patient Initials _________________
Anthem Blue Cross/Blue Shield
Optum/United Healthcare (UBH)
Behavioral Health Systems
Virginia Health Network
Services may be covered in full or in part by your health insurance or employee benefit plan. It is the responsibility of the PATIENT to check coverage limits, co-pays, and benefits. Please check your coverage carefully by asking the following questions:
- Do I have mental health insurance benefits?
- What is my deductible and has it been met?
- Do I have a co-insurance payment?
- What is my co-pay?
- How many sessions per year does my health insurance cover?
- What is the coverage amount per therapy session?
- Is approval required from my primary care physician?
Reduced fee services are available on a limited basis.
Cash, Check, or Credit/Debit are accepted means of payment.
If you do not show up for your scheduled therapy appointment, and you have not notified us at least 24 hours in advance, you will be required to pay a $60.00 "No Show" fee as stated above. Kindly remember that we have reserved our professional time for you. If you miss or cancel two appointments, then it is the policy of this group practice to terminate treatment.
Request a therapy appointment online here.
Questions? Please contact us for further information. You can reach our office @ 804-789-1224.