INSURANCE

All payment and communication with your insurance company is your responsibility. I will assist you by filling out the appropriate insurance forms which you will be responsible for submitting. Your insurance company will then reimburse you. Each insurance policy is different and you should contact them to get a full description of your benefits including co-pay, deductible and eligibility. I have no contract with any insurance company and therefore the treatment is considered “out of network”. Some employer benefits (often state, federal, county, city) provide for “out of network” benefits but many individual policies (ie Obamacare) do not.  

Please note that I do not accept Medicaid and I have “opted out” of Medicare which means that you will be responsible for the full amount without the option to submit to a secondary plan.

PROCEDURE CODES
These are the codes and descriptions which I use most frequently. You can contact your insurance company to find out if they reimburse for these procedures.

99205-Initial visit for new patient, 60 minutes*
99354-extended time, often used with 99205*
99212-evaluation and management,
99213-evaluation and management, 10-15 minutes, more often used with psychotherapy code*
99214-evaluation and management, without psychotherapy, 25 minutes*
99215-evaluation and management, without psychotherapy, 40 minutes*
90836-psychotherapy, up to 45 minutes*
90838-psychotherapy, up to 60 minutes
99358-extended time without face to face contact (ie insurance, schools, reports, hospitals, other professionals, family)

*codes most often used

APPOINTMENTS

In-peron or telehealth appointments are scheduled according to each patient’s schedule and individual needs and according to my availability. Missed appointments are charged in full unless there is a 24 hour notice or the result of a serious medical illness or family emergency. Your appointment time is reserved only for you so if you arrive late you may only use your remaining time but you will be charged the usual fee. Please note that if you fail to keep appointments or you repeatedly cancel appointments it will interfere with your treatment and it may result in termination of your treatment.

For all current patients, I will continue to provide telehealth via Zoom as long as you’re located in New York State. I am also able to provide telehealth for patients who are located in Florida, either permanently or temporarily. Click here for more info.

FEES

You or your legal guardian are responsible for the total cost of service at each visit. Please have a check or cash available. I can provide you with a list of my current fees and procedures.

MEDICATION REFILLS

I handle all refills during your regular scheduled appointment. Please check to see if you need any refills before your appointment. It can be uncomfortable or in some cases even dangerous to go without certain medications. It is important for your treatment to continue on the prescribed medication. There is a $25 administrative fee for refills between appointments for non-controlled medications and a $50 administrative fee for controlled prescriptions.

PRIOR AUTHORIZATION

Many insurance companies have cut back on the medications they will re-imburse. If your pharmacy informs you that your prescription is not covered and requires prior authorization, request that either the pharmacy or your insurance company initiate a prior authorization that will then be sent to me. This may require a telephone call on your part to your pharmacy benefit plan. The prior authorization can then be completed during our session or at a later time. If not completed during a session the charge based on time required to complete the authorization will be billed to you. The same applies to authorization for treatment.  In some cases this can be reimbursed by insurance.

FORMS AND REPORTS

Forms and reports that are not completed within the time of the session are billed according to the time required to complete them.