Payment & Insurance Information

BRIEF OVERVIEW OF INSURANCE

In this climate of changing mental health insurance coverage, we strive to make psychological services accessible and affordable. We keep weekly open slots for new clients so that when you call you do not have to wait for weeks to get in. Our goal at Lepage Associates is to provide the highest quality mental health professionals at a reasonable rate (for example, our therapy rate is $195 per session, at the low to mid end of the current average rate of $185-$250/hr). At Lepage Associates you work with an experienced specialist/doctor. (At times we may also have students or license-eligible therapists in training, however, when considering students we typically choose only those for whom psychology is a second career so they are already older/mature with much life experience, and typically are transitioning into mental health from other health fields or jobs in education.) All on-site services provided by Lepage Associates are insurance reimbursable through your out-of-network benefits. The majority of our clients who wish to use their insurance do get reimbursements from their insurance company to help cover the cost of services. We are very knowledgeable about insurance and can help you file claims and get reimbursed. The process is simple: you pay us for services rendered and your insurance company then sends the reimbursement check directly to you. We have claims forms for all major insurance plans at our office and can, if you wish, help you fill them out correctly and mail them in for you. Or, it is also very easy to file your own claims, which clients often prefer now since the advent of client portals allows you to track your claim online (which is not possible if we mail in a paper claim for you).

Though we do not participate on panels, all insurance plans (except HMOs and sometimes Tricare) will still reimburse for our services through out-of-network benefits; in addition, some plans reimburse the exact same amount whether you use someone on their panel or not, thus it may not cost you more to go out-of-network, or the difference may be quite minor (see below for more in-depth information). We have found that for most people it does not cost too much more to go out-of-network, and we have found that when it does cost more to go out-of-network, the difference is not large, and is often a price people are willing to pay to work with a clinician they like and trust. And though it seems “backwards,” we have also seen rare cases where it costs less to go out-of-network. Thus if you want to know exact information regarding benefits, it is best to call your insurance company; we are also happy to check on your insurance benefits for you as a courtesy at no charge. (We do take a limited number of reduced fee or pro bono clients. Please call to ask about availability.)

Tricare: Many of our therapists are authorized Tricare providers and are non-network providers. Non-network authorized providers meet Tricare licensing and certification requirements, and are certified by Tricare to provide care to Tricare beneficiaries. Thus an authorized non-network provider is authorized to provide care to Tricare clients wherein you can likely get reimbursed some amount for their services, but has not signed a network agreement. Thus our authorized non-participating providers provide psychotherapy to Tricare clients, but since we have not signed an agreement with Tricare, you pay us up front for full cost of the appointments, and then turn in the claim form to Tricare and Tricare will reimburse you directly since you have already paid. This process is quite simple and we see many therapy Tricare clients who get reimbursed for our services by Tricare. Note some of our therapists are not authorized Tricare providers, and when you use one of these providers, you cannot get reimbursed any percent at all by Tricare for any services. Many Tricare people still use these providers when they find someone they like, but with the knowledge all costs will be paid by you and you cannot turn in claims to Tricare for any reimbursement.

Evaluations/Psychological & Educational Testing for people insured by Tricare: Please note we do not have any authorized providers who do psychological evaluations for Tricare, which means if you use one of our evaluators who are not authorized Tricare providers, and when you use one of these providers, you cannot get reimbursed any percent at all by Tricare for any evaluation services. Many Tricare people still use these providers when they find someone they like, but with the knowledge all costs will be paid by you and you cannot turn in claims to Tricare for any reimbursement. If you are court-ordered to have a psychological evaluation we can do it, but note such forensic evaluations are not considered medically necessary and are thus not reimbursed by Tricare. Also, typically Tricare does not reimburse for psychoeducational evaluations, such as to diagnose learning disabilities or attention issues (such as AD/HD), however, if you served in the Special Forces please contact us, as a Special Forces Fund exists from a private benefactor that may be able to cover the psychoeducational evaluation you or your family member need. Again, we can do any and all evaluations and have a large testing center and many years of experience in testing, but Tricare does not reimburse for our services.

ADDITIONAL INFORMATION ON INSURANCE

Many people don’t realize that mental health benefits are sometimes reimbursed differently than general medical benefits. For example, if you pay a co-payment when you go to a medical appointment that does not mean you would pay the same co-payment for an appointment with a psychologist even in-network. Typically under their mental health benefits, insurance providers reimburse a percentage of what they refer to as an “allowable amount” or an “allowable fee,” and that percentage tends to be between 60% to 90% depending on your plan. This percentage may remain the same regardless of whether you see an “in-network” or “out-of-network” psychologist. Sometimes insurance providers do use a co-payment for mental health services. There is a wide range of variability between plans.

We try to simplify this for you! Prior to your first appointment, if you wish, we will be happy to assist you in understanding your insurance benefits for mental health services by contacting your insurer, so that you will be clear about what portion of our services will be reimbursed to you by your insurance company. In this way, you will know exactly what our services will ultimately cost you after your insurance carrier has reimbursed you. There is no fee for this contact, regardless of whether you decide to keep your first appointment or not.

So that our focus can remain 100% on assisting clients with their clinical concerns, we do not participate as members of insurance panels, however, as noted above we also keep our fees quite reasonable to ensure it will not cost you significantly more to go out-of-network and we can file your insurance claims for you if you wish.

All charges are your responsibility from the date services are rendered, and payment for services is due in full on the date services are rendered. As health care providers, our relationship is with you and not your insurance company. It is your responsibility, should you desire reimbursement to yourself, to either process the claim with your insurance provider yourself or ask us to do it for you. We will be happy to process your claim for you, or help you process your insurance claims for reimbursement by providing you with a receipt of services rendered, which contains all of the information needed for an insurance company to process a claim, and by helping you fill out your claim forms and mailing them for you.

You may, of course, also choose not to turn in your receipts for reimbursement, and simply utilize psychological services without informing your insurance company. We realize that some people prefer to bypass their insurance plans altogether because of constraints related to choice of therapist, number of sessions, treatment autonomy or concerns about confidentiality.

Please note our fees are very reasonable when compared with others in the field.
Note for all appointments online or at the office, your credit or debit card on file will be charged sometime before the appointment time so you are all checked in and ready to start at your scheduled time. (Typically it will be charged within the 24 hours before the session, though Monday appointments may be charged on the prior Saturday.) You will receive an email receipt of that payment (i.e., Superbill) sometime within the 24 hours after your session. Thus if in-person, you will not have to wait in line to pay (given COVID we are trying to ensure less time needed to gather in the waiting room). NOTE we do not accept cash or checks; if you don’t have a credit or debit card you can get a debit card from your bank, or purchase a prepaid debit card and use that with us.

Psychotherapy (includes all ages/therapy formats):

• 1st Appointment (Intake) / Diagnostic Interview (55 minutes): $195.00
• Therapy Session (45 minutes face to face): $195.00

• Therapy Session (55 minutes face to face): $225.00

• Therapy Session (75 minutes face to face): $275.00
• Group Therapy & Seminars per Session: $100.00
• Therapy or Non-Forensic Consult with Dr. Lepage: $350.00 per hour
• Reunification Therapy: $250 per 45 to 55 minute session, $375 for Diagnostic Interview of each parent, and for 75 minute sessions (if needed)

Psychiatry/Medication (Traditional Model):

• 1st Appointment/Diagnostic Interview ADULT (up to 45-60 minutes as needed): $385.00
• 1st Appointment/Diagnostic Interview CHILD (up to 60-90 minutes with child & parents as needed): $450.00

• Med Check/Med Management/Short Follow Up (15-20 minutes as needed): Child or Adult $185.00

• Long Follow-Up with Psychiatrist (up to 45-60 minutes as needed): Child or Adult $385.00
• Medication Refill (i.e., refill done outside of normal in-office session): $25.00 processing fee with 7 days’ notice, $75 with less than 7 days’ notice
.
• Collateral services by M.D. on your behalf (i.e., phone calls not including calling in a prescription, emails, reading reports, etc.) billed at $6.00 per minute.

Psychiatry/Medication (Concierge Medicine Model): 

Welcome to information on our membership model for psychiatric care! We are excited by this progressive model that will offer flexible communication and appointment options for prescription management. Membership tiers range based on clinical need, and create predictability in monthly psychiatry costs. This concierge medicine model emphasizes high accessibility, and ease of use.

• One flat monthly fee versus separate billing for services, that is: appointments; contact with your psychiatrist via phone, email, or text; collateral contacts such as with other providers, pharmacies for prescription refills; reading reports or anything related to your case; etc. — all fall under one monthly membership fee
• Concierge medicine tends to be a little more expensive than the traditional model, but works well for people who need or prefer more contact with their provider, or, want to ensure the option of high access if they want to use it at any time, as increased doctor availability is a hallmark of concierge care
• Most patients will fall at the $199 per month fee for ongoing care (this is referred to as the PREVENT tier)
• To start, all patients pay $349 for the first two months (the first month may be prorated lower if you begin mid month), then level of care is determined in discussion with the patient for future billing ($349 is referred to as the MANAGE tier)
• For patients who need an ADHD assessment by the psychiatrist, there is a flat-fee cost of $1,950 for computerized assessment. (Not everyone with attention problems needs this.) Typically, ADHD evaluations are done by Lepage Associates psychologists and include the breadth to rule out a variety of other learning issues in addition to testing for ADHD; this level of testing is required by educational institutions if you will be applying for accommodations for school or college. That cost is $3,000. However, if you need an assessment for ADHD that does not involve learning issues, and you will NOT need accommodations from school or college, Dr. Byrne’s ADHD assessment can be a great fit. Her assessment includes up to 3 computer tests of attention, psychoeducation around ADHD, and if desired, can bring in a family member or friend to help clarify the diagnosis and treatment plan.
• For patients who want to also do ongoing therapeutic work with the psychiatrist, a $1,950 per month coaching option is available (this is referred to as the COACHING tier)
• Please note concierge medicine services cannot be submitted to your insurance company, as a membership model to health care has no associated CPT codes since it is a flat fee for all time with the patient and/or doing collateral services in a month, thus there is no superbill; if you need to turn in receipts to your insurance for reimbursement, choose the Traditional Medicine model above
• The concierge medicine model costs a bit more and is ideal for people whose needs may be somewhat higher for contact with their provider, or, who simply like the enhanced access to their provider and/or the one monthly payment that concierge medicine includes. We are happy to be able to offer both models to meet the needs and preferences of all of our clients!
• FAQs on the Concierge Medicine Model for Psychiatry. 

Divorce-Related Therapy/Consult & Parenting Coordinator Services:

1. Child Specialist (co-parenting therapy; consult on divorce and kids; voice-of-the-child meetings with child; member of Collaborative Divorce team; parenting plan consult): $250.00 per hour ($350/hr. Dr. Lepage)
2. Divorce Coach (communication skill building for meeting preparation; identify needs/interests; emotional control for effective process; member CD team): $195/hr. ($350/hr. Dr. Lepage)

• A note about Reunification Therapy and Therapeutic Supervised Visitation: Reunification Therapy (RT) is a form of Family Therapy and is billed at $250.00 per session for up to 45-55 minute sessions face to face, depending on the session plan for the day and the ability of participants to engage; longer sessions of up to 75 minutes face to face are billed at $375.00. Because reunification therapy is a form of Therapy you should be able to turn in claim forms to get reimbursed some percent of sessions via your out of network benefits  Therapeutic Supervised Visitation (TSV) is a form of Family Therapy and is billed the same as regular psychotherapy. We do not provide non-therapeutic supervised visitation; however, because therapeutic supervised visitation is a form of Therapy you should be able to turn in claim forms to get reimbursed some percent of sessions via your out of network benefits, thus in the end TSV may cost you the same or less than non-therapeutic supervised visitation which cannot be reimbursed by insurance.
• Parenting Coordinator (court ordered): Dr. Tina Lepage $250.00/hour – Rae Ann Hamilton $200.00/hour

Career Counseling & Assessment/Testing:

• Testing + 2-counseling-sessions: $995.00
• Testing-only: $750.00
• 2-counseling-sessions-only: $390.00 (coded as 1 Diagnostic Interview and 1 Psychotherapy)
• Vocational Evaluation for Workman’s Comp: $995.00

Evaluations – Clinical & Forensic (the flat fees for evaluations include a free feedback session if you would like one): If you need a quick turnaround, we can often do this for you! Please call 919-572-0000 and ask for associated fees and timelines, or email: [email protected].

Psychoeducational/Educational/Academic/Neuropsychological/Executive Functioning:

• Psychoed Eval (AD/HD & LD evaluation + R/O MH issues): $3,500.00
• Addition of the Continuous Performance Test (CPT) only to a psycho-ed: $500.00
• Expanded Psychoed Eval (full psychoed + additional testing or history review, which may
  include the CPT as one item added): $4,500.00
• Full Battery (NON-Forensic) (Combined Expanded Psychological + Full Psychoeducational; a full testing battery to determine in-depth all cognitive, emotional, and personality factors; or a complex psychoeducational): $4,500.00
• FORENSIC Full Battery (i.e., for use related to a court case): $5,000
• Foreign Language Assessment (school accommodation for a foreign language) / Modern Language Aptitude Test (MLAT): $750.00
• Readiness for Kindergarten Testing: $950.00
• IQ Testing only: $750.00. Achievement Testing only: $750.00
• School observation: $200.00 per hour, port to port
• Neuropsychological/Executive Functioning: $3,500.00
• Expanded Neuropsych: $4,500.00
• Independent Educational Evaluation (IEE): $3,500.00
• Expanded IEE (full IEE + additional testing or history review,  or + observation): $4,500.00
• Functional Behavior Assessment with Half-Day School Observation (includes document review, school observation, up to 45-minute drive each way, and report/FBA): $2,500.00
• Functional Behavior Assessment without school observation (can do if there are already ABC data sheets because of behavioral accommodations in IEP or if there is a current BIP): $2,000.00 (plus $200.00/hour if it takes more than five hours)

Psychological Evaluations & Autism-Spectrum Evaluations:

• Psychological Evaluation (NON-Forensic): $3,500.00
• FORENSIC Psychological Evaluation (i.e., for use related to a court case): $4,000
• Expanded Psych Eval (NON-Forensic): (psych + some additional testing, expansive records review, or additional collateral calls past five): $4,500.00
• FORENSIC Expanded Psych Eval (i.e., for use related to a court case): $5,000
• Autism-Spectrum Disorder Evaluation (to assess for ASD): $4,000.00
• Expanded Autism-Spectrum Disorder Evaluation (to assess for additional mental health, learning disorder, and/or cognitive concerns): $5,000.00
• Comprehensive Clinical Assessment (CCA): $500 adult (non-forensic), $750 child, $750 (diagnostic interview and brief review of history to provide diagnosis and recommended treatment plan; no psychological testing, record review or collaterals except parents for a child, and current order and attorney for forensic)
• MMPI-2 only or MCMI only (no clinical interview): $250.00 (30-minute feedback session $100.00 additional to testing/write-up)
• Rorschach only (no clinical interview): $500.00 (30-min feedback session $100.00 additional to testing/write-up)
• Comprehensive Eating Disorder Assessment: $3,000.00
• Eating Disorder and Substance Abuse Assessment: $3,000.00
• Brief Eating Disorder Assessment: $1,250.00
• Eating Disorder Risk Assessment: $1,250.00
• Bariatric Evaluation: $1,250.00
•  Adoption Readiness or Egg Donor/Recipient: $3,000 for a couple or $2,500 for an individual (this includes interviewing and testing as required by your agency and a written report; if your agency requires considerably more than others, anything over 12 hours for a couple or 10 hours for an individual will be charged at $250 per hour)
• Emotional Support Animal Mental Health Evaluation & Letter: $995

• Other (non-forensic) psych testing: $250.00 per hour
• Forensic testing hourly: $250.00

Civil Forensic Evaluations: (Competency/Capacity such as medical or financial; Fitness for Duty/Return to Work; Disability; Workman’s Comp, etc.): Typically some format of a psychological, expanded psychological, or full battery depending on the case and what the needs are for amount and type of cognitive testing, emotional and personality testing, collateral contacts, review of collateral data, etc.

• Veteran’s Evaluation with Clinical Interview and Review of Records only (no psych testing): $995.00.

‘Regular’ Immigration Evaluations (i.e., emotional functioning impact/hardship of deportation of non-citizen on the U.S. citizen spouse or children; or asylum seeking; etc.): $995.00.

These are almost always of just an individual but since we have done some families, have included pricing here on that. For a family: Generally 1-hr interview child(ren) + 1-hr interview parents + write report 3hrs = $2,250.00 (for a family if up to 4). If adding testing for family or doing observations would be $250 per hour additional for those services.

To add psychotherapy: $195 first therapy session then $195 for each therapy session thereafter; sessions are about 45 minutes each and can be done in person or online, and we have two Spanish-speaking therapists. Therapy does not take the place of the immigration evaluation, but can be added.

Cognitive Immigration Eval for Citizenship Exam Waiver (N-648 Form): $1,500.00.

Clinical interview + cognitive testing to show a person may qualify for an exemption from the English language and U.S. Civics requirement for U.S. naturalization if there is the presence of physical or developmental disability or mental impairment. The cognitive battery would include: BNCE and WJ-Reading subtests (in Spanish); and as needed the PCL-5 for PTSD, BDI for Depression, and Records Review if needed pertaining to TBI or psychiatric hospitalizations.

Juvenile & Adult Forensic Evaluations: (If hourly, $250.00 per hour)

• Risk/Threat Assessment: $4,000.00
• Risk/Threat Assessment Expanded: $5,000.00
• Competency to Stand Trial: $4,000.00 (to $5,000.00 if expanded)
• Mitigation/Diminished Capacity: $4,000.00 (to $5,000.00 if expanded)
• Malingering Eval (mental health): $4,000.00; (cognitive): $5,000.00
• Sex Offender Eval (Juvenile or Adult): $4,000.00
• Substance Abuse Letter for Court (such as DWI): $995.00
• Substance Abuse Evaluations: $4,000.00

Custody & Visitation Evaluations / Parental Capacity Evaluations:

Note our use of flat fees allows you to know for certain the total cost of your evaluation, versus places that charge hourly. This is very important as it is not unusual for parties to pay $8,000+ as a retainer at the start of an hourly evaluation, only to receive a final bill at the end for another $6,000 to $10,000. With our flat-fee evaluation, there are no surprise bills, just one flat fee. (The only report where an hourly is used is for lengthy GAL cases.)

• Custody Evaluation w/ Testing Battery: $12,500 flat fee for a family of up to four ($1,000 each additional person) + costs for records of 2.50 per page or per minute for audio or video (records generally = another $200-$400).
• Extended Custody Evaluation (extended=additional collaterals): $15,000 flat fee for a family of up to four ($1,000 each extra family member) + costs for records.
• Custody Evaluation without testing: $9,750.00 flat fee for family up to four ($750 each additional person) + costs for records. (FYI people rarely ask for eval with no testing.)
• GAL Report: $5,000 retainer and minimum fee for up to family of four ($750 each additional person) + costs for records of 2.50 per page or per minute for audio or video (records generally = another $200-$400). If the case takes more than 20 hours, additional time is billed at $250 per hour, to a cap of $9,750.00.
• Effect of Parenting on Child Functioning Evaluation: $5,000.00 (such as Alienation)
• Parental Capacity (differs from custody eval – is of only ONE parent): $5,000.00
• Participation in Settlement Conference with parties & attorneys: $250.00 per hour port to port; we are also happy to host the settlement conference at our office as a neutral ground

Testifying & Depositions: (as fact witness or as expert witness): $350/hr. preparing for and at deposition or court; plus $195/hour port to port. PLEASE NOTE THERE IS AN ADDITIONAL TESTIMONY TERMS FORM YOU MUST FILL OUT IF YOU HIRE US TO BE DEPOSED OR TESTIFY.

Forensic Consult Services: In brief, by Dr. Lepage: $350.00/hour (example: being hired as a forensic expert to review a case); by other doctors: $250.00/ hour. We keep our fees very reasonable when compared to usual rates in this field. Your clinician may require you pay a retainer based on an estimate of time; this is an estimate and you may be billed for additional time used or may receive a refund for unused time. (1) Consultation: $250.00 per hour assisting forensic cases by reviewing case materials and providing feedback to attorneys and/or clients for their own use in the case (i.e., not for us to testify), excepting Dr. Lepage whose fee is $350/hr. If your consult is face-to-face meeting please note a “consult hour” includes 45-50 minutes meeting with the last 10-15 minutes for your psychologist to complete a meeting note. (2) Expedited Consultation = to be completed in under one week: $350.00 per hour all clinicians. (3) Forensic Expert to also Testify: $350.00 per hour reviewing a case and consulting on a case in preparation for our own testimony as a forensic expert.

Copies of Records: Records sent by us via email, $25.00 processing fee if the request can be handled administratively without clinician assistance, and $50.00 if the clinician must assist with the request. U.S. Mail: 25 cents per page additional fee for hard copies + $10.00 mailing fee. (FYI most requests for records can be handled administratively, but in some more clinically complex cases the clinician may need to assist.)

Collateral Services: Including phone calls, letters, email (reading or responding); telephone consultation (with psychiatrists, physicians, teachers, guidance counselors, attorneys, etc.); and meetings attended in your behalf port to port are billed: $50 for up to 15 minutes (or $75 for reunification therapy cases); $100 for up to 30 minutes (or $150 for reunification therapy cases), $185 for up to 45 minutes (or $225 for reunification therapy cases), and $225 for up to 60 minutes (or $300 for reunification therapy cases). For psychiatry, rate is $6.00 per minute and there is a 10-minute minimum billing for all psychiatry collateral services. You must have a credit card on file before your clinician can provide collateral services as payment is due at the time services are rendered.

Life Coaching: Our fees are the same as for therapy.

Other fees: Late Fees/Credit & Debit Card Declines/Returned Checks: For therapy and psychiatry, if you do not pay in full on the date services are rendered, 10% of the original charge will be added each week you are late, and for evaluations 10% of the total original charge will be charged one time. A $25.00 fee is charged for any credit or debit card decline. Regarding returned checks, you owe any fees the bank charges us for the bounced check, any fees for time we must spend talking with the bank or yourself to rectify the situation (billed at $195/hour), plus any late fees that apply. Regarding delinquent accounts, you are responsible for in full and will be charged for in full any and all time we spend trying to collect on the account (billed at $195/hour), and/or any and all fees of any outside services, such as an attorney or credit collector, hired to collect the debt.

Refunds: We do not offer refunds on any service for any reason.

Credit Card Payment: We do accept credit cards, and typically do not charge any additional fee for using your credit card. However, please note forensic consult services, custody evaluations, and testimony/deposition add a 3% convenience fee for use of credit cards.

Business Services: Call and ask for Dr. Lepage for more information.