Let’s talk about standard fees and payment options.
Dr. Maxwell is presently an in-network provider for Aetna, Ambetter, Blue Cross Blue Shield, Cigna, Magellan, Medicaid, Medicare, and Optum/United Healthcare.
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STANDARD OUT-OF-POCKET FEES FOR PSYCHOTHERAPY
Dr. Maxwell takes care to ensure that his standard out-of-pocket fees are competitive with those of other licensed clinical psychologists both nationwide and in comparable regions and cities.
First 15-minute consultation: FREE
90-minute initial intake (in-person): $300
90-minute initial intake (remote): $275
45-minute individual therapy session (in-person): $175
45-minute individual therapy session (remote): $150
30-minute individual therapy session (in-person): $90
30-minute individual therapy session (remote): $75
60-minute couples/family therapy session (in-person): $200
60-minute couples/family therapy session (remote): $175
Please note that many insurance carriers will provide partial reimbursement for fees as an out-of-network provider (see WHAT TO ASK YOUR CARRIER ABOUT OUT-OF-NETWORK BENEFITS below). At his client’s request, Dr. Maxwell will provide a Superbill (i.e., a detailed, itemized receipt used by healthcare providers to reflect the services we have provided) after each session for them to submit to their insurance carrier for this purpose.
Sliding scale rates may be available for clients in select circumstances (e.g., individuals and families at or below poverty thresholds put forth by the Department of Health and Human Services).
Dr. Maxwell is also able to accept payments from Health Savings Accounts (HSAs).
WHY PAY OUT-OF-POCKET FEES?
Although in-network benefits lower costs of psychotherapy, it may be worthwhile for clients to consider the following points:
Insurance reimbursement for services requires a diagnosis that becomes part of one’s permanent medical record.
Clients' records are not protected, which means all information about the client, including very personal information, may be obtained by the insurance company.
Clients' care is in a sense dictated by the insurance company as the therapist essentially works for the insurance company, not the client.
For these reasons, clients may prefer to use out-of-network benefits as insurance companies are very limited with respect to information they can request about clients who use out-of-network benefits. Importantly, clinicians are also often better able to meet clients’ needs rather than insurance companies’ needs.
WHAT TO ASK YOUR CARRIER ABOUT OUT-OF-NETWORK BENEFITS
To better understand what your insurance provider might reimburse for out-of-network psychological services, call your insurance company before scheduling an appointment or consultation. You may want to ask your insurance provider the following questions:
What do they reimburse for out-of-network psychotherapy services for the following CPT codes: 90791, 90834, 90837. Your insurance company will understand what a “CPT code” is, and whether they reimburse for these specific codes.
Is there a maximum number of psychotherapy sessions they will reimburse?
If the insurance reimburses a percentage of the cost, what is that percentage, and what is the maximum total cost per session they are allowing? For instance, they may reimburse 70% of a psychotherapy session (e.g., CPT code 90837), but assume that the total cost of the psychotherapy session is only $120 instead of the actual rate. This would mean the client would be reimbursed $84 per session, after paying a rate of $175-$325 out of pocket. Another company, however, may only reimburse 50%, but allow a $220 hourly rate, meaning that the client would be reimbursed $110 per session. Thus, it is important to understand both the reimbursement percentage and the maximum per-session rate allowed.
STANDARD FEES FOR ASSESSMENT AND CONSULTATION
Fees for psychological assessments for clients and consultations with other mental health professionals vary according to requested work. However, most comprehensive assessments range from $900 to $1200. Contact Dr. Maxwell to discuss your requests.