Fees

Do you have “disposable income” (income that is left over after paying for all of your expenses)?

Do you receive financial benefits (such as retirement matching, employee assistance, travel funding, and subsidized insurance) through your workplace?

Do you find that you are able to save a significant amount of money each month?

Do you own assets such as cars, homes, or other high-value property and belongings?

Do you have a job that offers flexible hours and the ability to work from home, such that you can attend therapy “on the clock?”

Do you have more than one source of income available to you?

Do you have money and time to provide community care through donations to charity and assistance to family and friends?

Do you have access to generational, communal, or familial wealth?

Do you have enough income so that you feel able to redistribute your wealth to others?

If you answered yes to most or all of these questions, please consider adjusting the fee you would expect to pay up to tier 4 or 5.

If you answered yes to some of these questions, please consider paying at tier 3.

If you answered no to most or all of these questions, please consider the questions in the next section to determine your fee.

Would four weeks of therapy be more than 5-10% of your monthly take-home income?

Do you have fluctuating or uncertain income?

Do you have family or community members who rely on you for financial support?

Do you have significant debt or are your wages garnished?

Do you have medical care needs that you pay for out-of-pocket already?

Do you face barriers, such as racial/gendered socialization and/or marginalization, that prevent you from being able to ask for what you need from others?

Will you have to use a credit card to pay for therapy? If you do, will you have difficulty paying your credit card bill?

If you have family who are financially comfortable, do you experience difficulty asking them for support?

If you answered no to most or all of these questions, please consider paying at tier 3.

If you answered yes to most or all of these questions, please consider asking for a reduced fee at tier 1 or 2.

There are several reasons why I do not work with insurance companies to cover the cost of therapy for my clients and will only accept out-of-pocket payment.

The first is that working with insurance to pay for therapy requires a not-insignificant administrative burden both for my clients and myself.

Working with insurance also requires me to provide a diagnosis in order for the payer to approve the cost of therapy as “medically necessary.” I do not see therapy as treatment only for medical necessity. Therapy is for everyone no matter their diagnosis or lack thereof.

In addition to the diagnosis requirement, insurance companies have the right to audit client records, again for the purpose of determining medical necessity. This both exposes your personal information to unknown parties and constrains our treatment, as the insurance provider can potentially dictate how our therapy progresses or refuse to pay for the treatment I provide.

In the context of all of this, using insurance to pay for therapy becomes a system of surveillance and policing of client care. I hold deep values of anti-carcerality and anti-surveillance within (and outside of) my therapy practice.

Ultimately, it comes down to the ethical boundaries that guide my practice, and it is against my ethics to participate in the insurance system.

One of my colleagues, Hannah Boes, says it best on her website:

“My priority will always be my clients’ privacy and their access to the highest quality care my training and expertise can provide. I have witnessed how insurance companies have made it difficult for providers to maintain these priorities, particularly in the realm of confidentiality and autonomy. This shows up in the form of frequent requests for the personal records of clients, placing constraints on the number and type of sessions clients can attend with coverage, inaccurate, slow, or nonexistent reimbursements, and attempts to influence or dictate treatment. [Not working in-network with insurance] allows us to keep decisions about the nature, course, length, and focus of treatment between us.”

Some insurance plans (usally PPO plans) allow patients to see providers who are not in their network. If you wish to submit out-of-network (OON) benefits claims, please inform me at our first meeting so that we may discuss this option. This involves me providing you with a “superbill” to submit directly to your insurance company. A superbill must include a diagnostic code. Please note that full payment is due at the time of services and that your insurance provider will, if they agree to coverage, reimburse you directly. I will have no authority to make decisions about your coverage or dispute denied claims. All clients wishing to submit their bill for out-of-network reimbursement will be charged my full out-of-pocket rate of $175.

My practice can accept payment via check, cash, or credit/debit card. This includes HSA/FSA cards.

Payment is due at the time of service. Clients will not be able to schedule a new appointment if a large balance accumulates on their account. If this occurs, I may be able to discuss a payment plan to lower the balance.

I request that new and returning clients please cancel any scheduled and confirmed appointments at least 48 hours before the appointment. Any appointments canceled less than 48 hours before the scheduled time will be charged a late cancellation fee, determined based on the client’s fee tier.

Cancellation fees:

Tier 1 - $15

Tier 2 - $35

Tier 3 - $35

Tier 4 - $105

Tier 5 - $105

These fees also apply to any initial sessions in which clients decide they will not continue therapy with me, as a discounted initial consultation rate. In addition, current clients who like to schedule “extra” sessions (in addition to regularly scheduled weekly or biweekly appointments) may refer to these fees.

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.

You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

For current group therapy rates, please see the page or flier for the specific group. There will typically be a 3-tier payment structure available.

The Gender Creatives group fees are $75/50/25 per person per session (total cost of $600/400/200 over the 8-week course of the group). Clients who pay in full at the start of the group will receive a discount of one group session respective to their fee tier (either $75, $50, or $25).