Insurance Coverage for Mental Health Treatment

Insurance policies differ in the extent to which they cover mental health treatment and the member cost (deductible/co-payment/co-insurance) amounts.  If you wish to use your insurance, check with your insurance company to clarify what your policy covers. There are various questions to consider (e.g., What is my member cost responsibility for therapy? What is the coverage amount per therapy session?). Insurance carriers often require that you be diagnosed with a psychiatric disorder. Some need detailed personal information about you, your treatment, and your progress in therapy for you to confirm coverage.


Does Dr. Fox accept insurance?

Dr. Fox does not participate with any commercial, self-pay, Medicare, or Medicaid insurance plans. I accept self-pay for services. Many insurance policies offer "Out of Network Coverage", which would, after any applicable deductible, reimburse you a percentage of my fee. 

If you are utilizing Out-of-Network Coverage, I can submit courtesy billing. Courtesy billing means that you will still pay the full appointment fee, but I will file the claims to your insurance on your behalf, and the insurance company will process the claim to your out-of-network benefits. You may receive an Explanation of Benefits and/or reimbursement after I submit these claims.

In some circumstances, your insurance plan may agree to develop an Exception Reimbursement Agreement with me to reimburse services at my rates. Contact me for more information about this option. 


What are the benefits of out-of-network psychological services?

  • Self-pay can mean a deeper personal investment in your therapy, which can lead to you getting more out of it.
  • Your therapy experience is more private - none of your records, diagnostic information, or authorization for services must go through insurance.
  • In some situations, using your out-of-network benefits can actually be more affordable or comparable to your standard copay to see an in-network therapist.
  • If you have a high deductible and haven't had any other medical expenses yet in the year, you are responsible for paying up to the deductible amount in psychological services fees out-of-pocket before your standard copy applies. This is the case where seeing an in-network therapist and out-of-network therapist can accrue effectively the same cost.
  • If a psychologist isn't constrained by only providing services they can bill to an insurance company, they are often able to spend more time and creativity crafting the perfect treatment plan for you. Especially if you would like to receive mental health services for a long period of time, this extra attention may benefit your progress. This is also true of services that are not intended to address a diagnosable mental health condition, such as couples counseling.
  • Less wait time. Especially for the less-known insurance plans, it can be very difficult to find a therapist who is in-network and accepting new clients. If you limit your search by insurance, you may have to spend months on a waitlist before seeing a therapist.

What are Dr. Fox's self-pay rates?

My rates are based on credentials, years of experience, and the type of service. I utilize evidence-based treatment and prioritize the quality of care for each person I serve. Please feel free to contact me for more information about my rates and any other services which may not be listed on this page.

Service (CPT Code) Rate

Psychiatric diagnostic evaluation (60-90 minutes) (90791)

$225.00

Individual 45-minute Session (90834)

$150.00

Individual 60-minute Session (90837)

$185.00

Couples/Family Session (90847 or 90846)

$175.00

Psychotherapy for crisis (60 minutes) (90839)

$200.00

After hours appointments (99050). Appointments scheduled to start at 6pm or after.

additional $20.00

Medical Documentation (e.g., disability certification and special accommodations)
related to a psychological condition (e.g., Emotional Support Animal certifications, etc.)

$200.00

Psychological Assessment

The self-pay rate depends on the type of testing needed. The total rate includes the in-person testing sessions, Dr. Fox’s time required to read records, consultations with other psychologists and professionals, scoring of tests, interpreting the results, and any other activities to support these services. The rate also includes the feedback session to discuss results and recommendations. 

Assessment Fees

  • ADHD assessment  - $1,500
    • This includes up to 6 hours of test administration, 1-2 hours of reviewing medical records and /or collateral interviews, scoring and processing results, a complete report, and final hour feedback session to discuss results and recommendations.
    • For those seeing to determine a diagnosis for medication or workplace accommodation: this evaluation is not sufficient to receive accommodations in educational settings or on national or professional licensure standardized tests.

  • Learning disability/neuropsychoeducational assessment - $2,500.00
    • This includes up to 12 hours of test administration, 1-2 hours of reviewing medical records and/or collateral interviews, scoring and processing results, a complete report, and final hour feedback session to discussion results and recommendations.
    • For ADHD, Learning Disorders, emotional and behavioral functions, and to receive accommodations in educational settings or on a national and professional licensure standardized tests.

  • Psychodiagnostic assessment - $1,500
    • This includes up to 6 hours of test administration, 1-2 hours of reviewing medical records and/or collateral interviews, scoring and processing results, a complete report, and final hour feedback session to discuss results and recommendations.
    • Additional services beyond psychological testing services (e.g., additional feedback sessions, crisis management, medication referrals, etc.). - $225/ hour
    • Additional documentation following the conclusion of psychological testing - $200 - $400

Scheduling Fees

  • $500 – nonrefundable

Rush Fees

Results are available on a standard of 15 business day turnaround. If you need results in less than 15 business days, please see the rates below:
  • 13-14 business days - $500
  • 10 – 12 business days - $1,000
  • 7 - 9 business days - $1,500

To maintain the quality of the assessment, Dr. Fox cannot accommodate requests for results in less than 7 business days 

* Sliding scale and reduced fees are not offered

How and when do I make payment for services?

Your payment or member cost is due at the time of your appointment. I accept cash (exact amount), credit/debit/FSA/HSA cards, or personal check.  Payment plans are not available. Dr. Fox requires all patients to keep a credit card on file even if they are paying by other methods.

What is Dr. Fox's Cancellation and Rescheduling policy?

If you need to cancel or reschedule an appointment, please do so at least 24 hours before the appointment. Your appointment time has been reserved specifically for you; therefore, you will be billed a fee for late cancellations or missed appointments. The fee is $200.00. Missed or late cancelled appointments are not reimbursable by insurance.  Persistently missed appointments may result in termination of care. 

What is a Good Faith Estimate?

  • Dr. Fox provides Good Faith Estimates (GFE) as a part of the onboarding process for new patients and before an initial appointment is scheduled. 
  • According to the law, health care providers need to give patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services.
  • You have the right to receive a GFE for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, or any other provider you choose, for a GFE before you schedule an item or services.
  • If you receive a bill that is at least $400 more than your GFE, 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 GFE, visit www.cms.gov/nosurprises or call 1-800-985-3059.

Contact Me Today!

I invite you to contact me if you have additional questions regarding my rates or the insurance programs I participate with.