*Lower Sliding Scale Options

In cases of financial hardship, I am able to further extend my sliding scale to as low as $150 - $180/session for individual therapy sessions, and as low as $165 - $200/session for couple & family therapy sessions.

My practice defines “financial hardship” as double the OHP Bridge eligibility criteria (earning income at 200% of the Federal Poverty Level), or earning lower than 400% of the FPL: $42,400/individual or $57,500/family of 2. I am flexible to further negotiation if you earn more than the listed amount but still need to request a lower rate. Please ask for what you need!

**More Information about Insurance and Couple/Family Therapy

I have looked deeply into the question of how to bill insurance for couple/family therapy, as it is an area of legal and ethical confusion in the field. What I have found is the following:

Couple and Family therapy will only definitively be covered by insurance when the purpose of therapy is to support the covered member with managing symptoms of a mental health diagnosis, with the other person(s) acting as a “collateral” or support person. This looks like the covered member’s symptoms needing to be focused on for the majority of time in treatment - in other words, there is an unequal focus on one person over the other.

Conversely, traditional or systemic couple/family therapy looks like the therapist treating the relationship as the client, with an equal emphasis on all parties’ needs, symptoms, and concerns. In systemic couple/family therapy, a therapist can’t arbitrarily pick one person to be “the client” while doing therapy with all people present. As a licensed marriage and family therapist who practices Systemic Therapy, I have been advised that unless there is an individual diagnosis being treated with medically necessary evidence-based treatment and collateral support, I must treat the entire couple/family system as my client.

All of the above creates a conflict with insurance: when the primary purpose of therapy is to improve the relationship, with equal emphasis on all parties, and without the primary goal of treating symptoms of a mental health diagnosis, services are referred to as “enrichment counseling” and are not considered medically necessary. Billing for services that are not considered medically necessary could result in the insurance company recouping their payments and potentially even regarding the sessions as insurance fraud.

For this reason, I offer two distinct services to couples and families: collateral therapy (treating one person with another’s support), and enrichment counseling (working equally with all members). Collateral Therapy is covered by insurance, Enrichment Counseling is not.

Prior to completing a consultation and intake, I am unable to guarantee any couple or family can use their insurance for relational services. The initial consultation is always free, and is followed by three intake sessions: two individual, and one conjoint. I bill the intake sessions at a flat fee of $100/session.* If medical necessity is determined following the intake, I bill further sessions to the insurance company. I can also provide a superbill for the intake sessions should you seek to pursue insurance reimbursement.

Completing an assessment is not a guarantee of treatment coverage by insurance - through the course of the assessment we may find that medical necessity has not been met, in which case you will need to proceed using an insurance waiver and pay out-of-pocket.

*For OHP clients, per OHA guidelines, all sessions are $0 out-of-pocket, and will be billed to your insurance if medical necessity is determined.