No Surprises Act
Good Faith Estimate + Our Fees
What is the No Surprises Act?
The Federal No Surprises Act aims to increase price transparency and reduce the likelihood that clients receive a “surprise” medical bill by requiring that providers inform clients of an expected charge for a service before the service is provided.
Starting January 1, 2022, behavioral health care providers will be required by law to give uninsured and self-pay clients a good faith estimate of costs for services when the client requests an estimate.
Glenview Counseling Group always discusses pricing with new clients prior to scheduling their first appointments and will continue to do so. However, if you would like a formal Good Faith Estimate (GFE), please know that you can ask for one and that the law requires that this GFE will become part of your medical record.
Good Faith Estimate
You are entitled at any time to request Good Faith Estimate (GFE) for any procedure here at GCG. Here are a few things to help you navigate this request:
Only those who are paying for services out of pocket AND are not planning to submit to insurance are eligible at this time to request a GFE.
You may request a GFE prior to the first session, between sessions or at any time during your care.
Your GFE will have a diagnosis attached. If you have not yet been seen by one of our counselors when you make your request a provisional diagnosis will be determined.
You may request that the GFE be delivered to you in written or electronic form.
When requesting the GFE, please ask your counselor directly.
Your GFE will become part of your electronic medical record.
Our Fees
Below please find our out-of-pocket fees and procedure codes to match. These fees apply to anyone who is not using insurance at our practice or anyone who is not eligible for a sliding scale fee schedule.
Most Common Procedure Codes and Prices
The following six procedure codes account for over 95% of the codes that we bill at our practice. Please review them and let us know if you have any questions at all regarding any part of the following codes.
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This is a 30 minute individual counseling session. A second person (such as a parent) my be present for a short time during the session, but the focus of the session is on the individual needs of the single client. This session may be between 23-37 minutes.
Cost: $130
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This is a 45 minute individual counseling session. A second person (such as a parent) my be present for a short time during the session, but the focus of the session is on the individual needs of the single client. This session may be between 38-52 minutes.
Cost: $175
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This is a 60 minute individual counseling session. A second person (such as a parent) my be present for a short time during the session, but the focus of the session is on the individual needs of the single client. This session may be between 53-67 minutes.
Cost: $175
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This is the first (and sometimes second) session of counseling. It is meant to be a diagnostic interview where background information is compiled, rapport can begin to be established, and a diagnosis can begin to be formulated.
Cost: $205
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This is a family counseling session. It is used when subject of the session is a relationship within the family, such as couples counseling or traditional family therapy. Two or more people must be present in counseling during this session.
Cost: $175
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This is a family counseling session. It is used when subject of the session is a relationship within the family, such as couples counseling or traditional family therapy. The identified client in the records must be absent from the session.
Cost: $175
Less Common Procedure Codes and Prices
The following procedure codes and definitions account for less than 5% of the codes that we bill at our practice. Please review them and let us know if you have any questions at all regarding any part of the following codes.
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This is a 60 minute individual counseling add-on used when an hour-long session goes over time between 53-67 minutes or when a session is scheduled to go 53-67 minutes past 60 minutes. It is charged alongside the 90837 code and the charges are added.
Added Cost: $175
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This is an individual or family counseling code used when a client requires urgent assessment and treatment. The severity of the presenting issue on the counseling must also be more significant. It is billed for the first 60 minutes of a client in crisis.
Added Cost: $205
Other Fees
Missed Appointment Fee: The fee for a missed appointment is $175 except in the case of a scheduled half hour session, when the fee is $130.
Late to Session Fee: When a client is late to session we are unable to bill insurance for time not spent "face-to-face." While the occasional lateness may be understandable, chronic tardiness causes our counselors to spend time waiting for clients to arrive without being able to be reimbursed for that time. For clients who are chronically later than 10 minutes to session there is a fee of $50 per tardiness.
Travel Fee: These are used when we are occasionally asked to travel to a meeting outside of the office or to facilitate counseling in another setting, when appropriate. The charge for travel is $175 per hour prorated in 15 minute increments.
Court- or Legal-Related Charges: $400 per hour for any services that our counselors are asked to perform that are in service of legal proceedings (eg: custody disputes, mental fitness evaluations, etc.).
Questions?
If you have any questions about the meaning of any of these procedure codes please don't hesitate to ask your counselor, or you may reach out to our Clinic Director, Michael Blumberg.