Fee Agreement

PAYMENTS FOR SERVICES ARE DUE AND SHALL BE ABLE TO BE CHARGED TO CREDIT CARD SECURELY ON FILE IMMEDIATELY AFTER EACH SESSION, PER THERAPIST DISCRETION

FEES FOR SERVICES:

Individual couple, family, or parenting therapy: $250 per 50-minute session ($5.00 per minute)
Couple, family, parenting or coparenting therapy for couples considering separation/amicable divorce, or divorcing within collaborative law system: $250 per 50-minute session ($5.00 per minute)
Court-involved family therapy (CIFT) for divorcing coparents within adversarial court system: $275 per 50-minute session ($5.50 per minute)
Court-appointed reunification family therapy or court-ordered/recommended family therapy*: $295 per session (not reimbursed by insurance)
Emails, calls or texts regarding therapeutic advice/review: $5 per minute
Emails, calls or texts regarding scheduling: No charge
Illness/other cancellations with more than 24 hours' notice: No charge
Non-illness cancellations with less than 24 hours' notice**: $100 (not reimbursed by insurance)
Client no show: $250 (not reimbursed by insurance)
Client-requested sessions outside business hours: Double rate

* Requires a signed agreement listing detailed fees, and a deposit held in a savings account until termination of services.

** When cancelling, PLEASE give as much notice as possible, in consideration for other clients looking for openings.

INSURANCE REIMBURSEMENT:

I am adequately licensed/credentialed so clients can be reimbursed by insurance plans that provide for OUT OF NETWORK (OON) OUTPATIENT COUNSELING SERVICES. Statements/superbills are provided for client-filed OON reimbursement claims. Please contact your insurance company to familiarize yourself with your insurance plan’s coverage parameters.

AGREEMENT:

Client agreement indicates that client has read, understands, and agrees to the “Fee Agreement” policy. Provision of this document implies provider’s signed agreement.