Fees and access
Published rates, real sliding scale places, and no surprises at the end of the month.
Hiding fees behind a contact form wastes everybody's time. Here is exactly what this costs, how out of network reimbursement works in New York, and what to do if the number does not work for you.
| Service | Length | Fee | Notes |
|---|---|---|---|
| Consultation call | 15 minutes | Free | No notes taken, no obligation, no client record created. |
| Individual session | 50 minutes | $215 | The standard weekly session, in person or by secure video. |
| Extended session | 80 minutes | $320 | Occasionally useful for trauma work. Agreed in advance, never assumed. |
| Reduced fee place | 50 minutes | $95 to $165 | Limited places held at all times. No means testing paperwork required. |
| Late cancellation | Under 48 hours | Full fee | Waived if we can move the session inside the same week. |
| Monthly superbill | Issued monthly | Included | Sent automatically for out of network claims. You never have to ask. |
Fees are reviewed annually and existing clients are given at least sixty days written notice of any change. There are no packages, no prepaid blocks and no minimum commitment.
How out of network reimbursement actually works
Most people assume out of network means paying everything themselves. Frequently it does not, and the gap between what people assume and what their plan pays is often several thousand dollars a year.
The mechanics are simple. You pay me the session fee at the time of the session. At the end of each month I email you a superbill, which is an itemised receipt with the service codes, the diagnosis code, my licence number and tax identification. You submit that to your insurer through their app or portal. If your plan has out of network mental health benefits and you have met the out of network deductible, they reimburse you directly.
The four questions to ask your insurer
Call the member services number on the back of your card and ask these. It takes about ten minutes and it is the single most valuable phone call you will make about this.
- Do I have out of network outpatient mental health benefits, and what percentage of the allowed amount do you reimburse?
- What is my out of network deductible for this year, and how much of it have I already met?
- What is your allowed amount for CPT code 90837, a 60 minute individual psychotherapy session, in the 10011 zip code?
- Is there a session limit per year, and do you require pre authorisation for outpatient therapy?
Write down the name of the person you spoke to and a reference number for the call. Insurers are considerably more consistent when you can quote a prior conversation back to them.
Medicaid, Medicare and HSA
I do not accept Medicaid or Medicare, and I cannot see clients whose only coverage is Medicare even on a private pay basis under current rules. If that is your situation, tell me on the consult call and I will point you towards clinics and clinicians in the city who can help, because being turned away with no onward route is worse than useless.
HSA and FSA cards are accepted for session fees, which for many clients is a straightforward way to reduce the real cost by a meaningful margin.
If the fee does not work
Say so on the call. It is not an awkward conversation for me.
Roughly a third of the people who contact this practice raise money at some point in the first conversation, usually apologetically. There is nothing to apologise for. Therapy in New York is expensive and pretending otherwise helps nobody.
If a reduced place is available, we agree one. If none is available, I will tell you that plainly and give you specific alternatives rather than a vague suggestion to look around: training institutes where advanced trainees see clients at low cost under close supervision, community clinics, and colleagues who hold sliding scale places of their own. I keep that list current because I use it regularly.
What I will not do is quietly let you overextend. A therapy that you cannot afford becomes another source of stress, and a client who is anxious about the bill cannot use the hour.
Questions
Fees, insurance and the fine print.
Why are you out of network rather than in network?
In network rates in New York are set low enough that clinicians have to see far more clients per week to make the practice viable, which affects the quality of attention every one of them gets. Panels also require disclosing a diagnosis and clinical detail to the insurer. Staying out of network lets me keep a smaller caseload, keep records minimal, and publish fees openly.
How much will my insurance actually reimburse?
It varies widely. Many New York PPO plans reimburse between fifty and eighty percent of an out of network session once the out of network deductible is met. Some reimburse against a lower allowed amount rather than the full fee. Call the number on your card and ask the four questions listed on this page and you will know within ten minutes.
What is a superbill?
An itemised receipt containing everything an insurer needs to process an out of network claim: dates, service codes, diagnosis code, my licence and tax details. I issue one automatically at the end of each month. You submit it through your insurer's portal or app, which usually takes a few minutes.
How do the reduced fee places work?
I hold a set number at any time. There is no means testing paperwork and no requirement to prove hardship. You tell me what is sustainable on the consult call, and if a place is available we agree it. Reduced places are reviewed at six months, in case your situation has changed in either direction.
What is a Good Faith Estimate?
Under the federal No Surprises Act, clients who are not using insurance are entitled to a written estimate of expected costs before treatment begins. I provide one automatically. It sets out the session fee and an estimate for the expected course of care, and you can request an updated one at any point.
What happens if I miss a session?
Forty eight hours notice or more, no charge. Inside forty eight hours the session is charged at the full fee unless we can move it within the same week. Genuine emergencies are handled with common sense.
Bring the money question to the first call
Fifteen minutes, free, and we can settle whether the fee works before either of us invests any more time in it.