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 $165 per session, at the low to mid end of the current average rate of $150-$195/hr). At Lepage Associates you work with an experienced specialist/doctor. 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) 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: Most of our therapists are authorized Tricare providers, but we are non-network providers. Non-network providers meet Tricare licensing and certification requirements, and are certified by Tricare to provide care to Tricare beneficiaries. Thus a non-network provider is authorized to provide care to Tricare clients, but has not signed a network agreement. As non-participating providers, we 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.
Evaluations/Psychological & Educational Testing for people insured by Tricare: Please note we do not do psychological evaluations for Tricare. 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.
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): $165.00
- Therapy Session (55 minutes face to face): $195.00
- Therapy Session (75 minutes face to face): $250.00
- Group Therapy & Seminars per Session: $100.00
- Therapy or Non-Forensic Consult with Dr. Lepage: $350.00 per hour
- 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.
Divorce-Related Therapy/Consult & Parenting Coordinator Services:
- 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): $200.00 per hour ($350/hr. Dr. Lepage)
- Divorce Coach (communication skill building for meeting preparation; identify needs/interests; emotional control for effective process; member CD team): $165/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 the same as any therapy noted above under Psychotherapy. Therapeutic Supervised Visitation (TSV) is a form of Family Therapy and is billed the same as any psychotherapy as well. (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: $750.00
- Testing-only: $750.00
- 2-counseling-sessions-only: $360.00 (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):
- Full Psychoed Eval (AD/HD & LD evaluation + R/O MH issues): $2,500.00
- Addition of the Continuous Performance Test (CPT) only to a psycho-ed: $300.00
- Expanded Psychoed Eval (full psychoed + additional testing or history review, which may
include the CPT as one item added): $3,500.00
- Full Battery (Combined Expanded Psychological + Full Psychoeducational; a full testing battery to determine in-depth all cognitive, emotional, and personality factors; or a complex psychoeducational): $3,500.00
- Foreign Language Assessment (school accommodation for a foreign language) / Modern Language Aptitude Test (MLAT): $750.00
- Readiness for Kindergarten Testing: $850.00
- IQ Testing only: $750.00. Achievement Testing only: $750.00
- School observation: $200.00 per hour, port to port
- Neuropsychological/Executive Functioning: $2,500.00
- Expanded Neuropsych: $3,500.00
- Independent Educational Evaluation (IEE): $2,500.00
- Expanded IEE (full IEE + additional testing or history review): $3,500.00
- Functional Behavior Assessment with Half-Day School Observation (includes document review, school observation, up to 45-minute drive each way, and report/FBA): $1,800.00
- 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): $1,000.00 (plus $200.00/hour if it takes more than five hours)
Psychological Evaluations & Autism-Spectrum Evaluations:
- Psychological Evaluation: $2,500.00
- Expanded Psych Eval: (psych + some additional testing, expansive records review, or additional collateral calls past five): $3,500.00
- Autism-Spectrum Disorder Evaluation: $3,500.00
- 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: $2,500.00
- Eating Disorder and Substance Abuse Assessment: $2,500.00
- Brief Eating Disorder Assessment: $1,250.00
- Eating Disorder Risk Assessment: $1,250.00
- Bariatric Evaluation: $1,250.00
- Adoption Readiness: $1,750.00 couple/$1,450 1-person; Egg Donor/Recipient $1,450
- Emotional Support Animal Mental Health Evaluation & Letter: $750
- Other (non-forensic) psych testing: $200.00 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.): $750.00.
These are almost always of just an individual but since we have done some families, have included pricing here on that.
For individuals: Generally 1-hr interview + PDSQ or SCL-90 (English or Spanish version) and 2 hrs to write a report = $750.00.
Complex case with a longer interview would be $1,000.00. For a family: Generally 1-hr interview child(ren) + 1-hr interview parents + write report 3hrs = $1,250.00. If adding testing for family or doing observation would be $1,500.00 or more based on $250 per hour.
To add psychotherapy: $195 first therapy session then $165 for each therapy session thereafter; sessions are about 50 minutes each and can be done in person or online, and we have 3 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: $2,500.00
- Risk/Threat Assessment Expanded: $3,500.00
- Competency to Stand Trial: $2,500.00 (to $3,500.00 if expanded)
- Mitigation/Diminished Capacity: $2,500.00 (to $3,500.00 if expanded)
- Malingering Eval (mental health): $2,500.00; (cognitive): $3,500.00
- Sex Offender Eval (Juvenile or Adult): $3,500.00
- Substance Abuse Letter for Court (such as DWI): $500.00
- Substance Abuse Evaluations: $2,500.00
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 $6,000 to $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.
- 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.)
- Effect of Parenting on Child Functioning Evaluation: $3,500.00
- Parental Capacity (differs from custody eval – is of only ONE parent): $3,500.00
- 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 $165/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 at the same corresponding rate, i.e., therapy, psychiatry, consult rate, etc. For therapy rate $165/hr, $2.75 per minute. For DC/PC rate $200/hr, $3.33 per minute. For rate of $250 or $350/hr, charge $4.17 or 5.83 per minute. Note there is a 5-minute minimum billing for all 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: $225 intake; Packages: (a) 30 minutes of coaching per month, via telephone or in person = $180 per month; (b) 60 minutes of coaching per month, via telephone or in person, follow up email after each coaching call = $250 per month; (c) Three pre-arranged 30 minute coaching calls per month, follow up email after each coaching call = $325 per month; (d) informal coaching process or one 45-minute session as needed after you have completed your coaching program, or if you have an additional issue you want to discuss = $150 per 60 minutes.
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 $165/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 $165/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.