I charge $220 for a full, 60-minute psychotherapy session. Some clients have the resources to pay “out of pocket” and prefer not to use their health insurance to help pay for treatment. For those who do opt to use their health insurance, I am paneled with Evernorth/Cigna and Lyra Health. Prospective clients with those health insurance plans should confirm whether they have a yearly deductible and what their copay is for outpatient mental health treatment provided by an “in network” psychologist. I submit service claims directly to Evernorth/Cigna and Lyra Health, so clients with those plans only need to tend to their portion of the cost of services when they meet with me.
I can also provide treatment for clients who want to use other insurance plans, but seeing an “out of network” provider is often much more costly than an “in network” provider. Such clients pay my full fee upfront, and I provide them with a “superbill” they can submit to their insurance plan for partial reimbursement. The amount of reimbursement will vary depending on the details of each insurance plan, but could be as little as half or even less of my fee, or perhaps more. Furthermore, often the reimbursement process is time consuming and complicated, and requires considerable attention to detail and persistence.
In keeping with the 2022 federal No Surprises Act, I provide “private pay” clients with an initial “good faith estimate” of the cost of the treatment they may receive from me. Upon request, I can also provide such estimates to clients who choose to use a health insurance plan to help cover the costs of services. Here are two examples of such estimates, one for a hypothetical client who is making use of insurance to pay for services, and another for a private pay client who is paying for services out of pocket. Although it isn’t possible for me to anticipate precisely how many psychotherapy sessions may be appropriate for a client, I provide clients with a form that includes an estimate of the number of sessions and associated cost. The total cost will depend on the number of psychotherapy sessions attended, and that will vary depending on the nature of the concerns we are addressing, the efficacy of the treatment I provide, adherence to treatment recommendations, and individual circumstances. I may provide an updated estimate as treatment progresses. The estimate I provide does not include the cost of additional treatment a client may seek from other providers, such as psychiatrists. The estimate is not a contract and does not obligate a client to obtain services. Clients may disagree with the estimate, may choose not to participate in treatment, and even if they do engage in treatment may choose to discontinue at any time. The No Surprises Act stipulates that if the actual amount I end up charging a client is $400 or more than the estimate I provide, the client has the right to initiate a dispute resolution process. A client’s decision to initiate a dispute resolution process will not impact the quality of services they receive. Clients can initiate a dispute resolution process by visiting the No Surprises Act website or by calling the help desk (800-895-3059). I encourage clients to discuss with me any questions they have regarding their good faith estimates.
All payments are due at the time of service, and can be settled via check, cash (exact change), or credit or debit card (Visa, Mastercard, Discover), including Health Savings Account and Flexible Spending Account cards.
People who have limited financial resources or insurance can seek treatment for mental health concerns from a range of low cost providers in San Diego.
Steve Sprinkle, PhD 