Fees and Payment

Unfortunately, insurance reimbursement for psychiatric services remains inadequate, which is why many psychiatrists are unable to accept the low reimbursement. Those that do often compensate for low payment with high volumes, and try to see 3, 4 or more patients per hour. This is not how I operate. 

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In my private practice,  I do not accept any private insurance (so I am a "out of network provider").  Fees charged are in line with other local practices and I will discuss them with you on the phone. 

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I do not accept Medicaid.

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I can accept a small number of Medicare patients, but you will have to submit paperwork for secondary plans (if any) on your own.

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Payment is due at time of service. Checks, Zelle, debit cards, FSA (flexible spending account cards), credit cards, Google pay, Apple pay and bank online bill pay are accepted.

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Many insurance companies will permit patients to see out of network providers, and will reimburse you 50-75% of the fee. I will provide you with a statement of charges which you can submit to your insurance company for reimbursement.

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If you would like an estimate of what your insurance company might reimburse you, here are some of the codes commonly used in my practice: 

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Initial visit:

90792:  Psychiatric Diagnostic Interview with Medical Services 

99204+99354: New outpatient level 4 (typically 45 min) plus prolonged service code (75-119 min total for level 4 visit)

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Follow Up Visit:

90833+99213:  30 min visit (therapy + short exam for purposes of medication management)

90836+99214: 60 min visit (therapy + longer exam for complicated medication management or problem)

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At this point, you might be very frustrated, since you pay substantial premiums for your health insurance and think it should cover your mental health care. You are exactly right--your health insurance should pay for your mental health care! But often insurance companies do not, thus cleverly shifting the cost burden back to patients. Many private insurance companies have a list of "in network" providers. Certainly check there first. Unfortunately, many of these lists are woefully out of date. This has been the subject of multiple lawsuits of violation of healthcare parity, as patients are forced to go "out of network" to get the mental healthcare they need.

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To learn more, read about the Mental Health Association 2014 study that found "only 43 percent of  [>1100] listed psychiatrists were reachable, with many out of date phone numbers or addresses. More than 10 percent of providers who could be reached indicated that they were not even psychiatrists. Many of the doctors contacted had extremely long wait times. Only one in seven psychiatrists were accepting new patients and available for an appointment within 45 days."   

https://www.mhamd.org/what-we-do/services-oversight/maryland-parity-project/

Also https://mdpsych.org/2017/12/apa-and-mps-advocate-for-network-adequacy/

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I advocate for expanded mental health and substance abuse treatment options for all patients, and fair and adequate reimbursement for providers so more will be drawn to the field and able to meet the unmet need. 

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In the interim, I am running my private practice as an individual doctor, providing high quality care to a small number of patients. I am not a mental health clinic or a group practice. I do not have a administrative, billing or coding staff in my practice.  This has some advantages:  You get to speak to me directly.  I can often return calls and arrange appointments very quickly.  I can focus my energies on the patient during the session, and spend time collaborating with other healthcare providers and carefully formulating your treatment plan. Your treatment is very private.  This practice arrangement also has some disadvantages: I don't have have an office team to take care of paperwork, and I don't have team (social work, nursing, case management, group therapy) for patients who need comprehensive multidisciplinary mental health care. 

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