What are your fees?

Fees vary by provider and service type.

Therapy Services: Forty-five minute therapy appointments are $210 with a licensed therapist and $225 with a licensed psychologist . The initial intake (75-minutes) with a licensed therapist is $320 and $340 with a licensed psychologist. Please inquire directly about fees for Dr. Pavlidis, who bills at a higher rate. Please read on for information about insurance and how billing works.

Evaluation Services: Comprehensive evaluations involve a time intensive process.  The cost is based on the time spent by the provider, which is impacted by the complexity of the evaluation. The total cost typically starts at about $3500, with most evaluations landing in the $4000 to $4500 range. Costs can exceed this range, depending on the provider and time involvement.

Are you on my insurance? 

We are not in-network with insurance. Child and Teen Solutions is a private pay clinic. 

How come you don’t take insurance?

Insurance reimbursement rates for mental health services are low, making it difficult, if not impossible, to pay private practice clinicians a living wage in Seattle.  Our rates are based on what is needed to employ and retain top talent in the field of child psychology.

Additionally, insurance often requires a formal diagnosis for reimbursement, which might lead to over-diagnosing or misdiagnosing clients in order to meet insurance criteria. Insurance companies may limit the number of sessions they cover, which might not align with the client’s treatment needs. Submitting claims to insurance companies involves sharing sensitive patient information, which some families might prefer to keep confidential. By not accepting insurance, practitioners can focus more on the quality of care rather than on the extensive administrative matters involved in taking insurance. 

In contrast, large agencies such as hospitals generally have the capacity to take insurance for mental health services because they have the resources and infrastructure to manage the complexities and administrative burdens associated with insurance claims. Hospitals often have dedicated billing and administrative staff who specialize in handling insurance claims, ensuring compliance with insurance requirements, and managing the associated documents. Hospitals also typically have more bargaining power with insurance companies, enabling them to negotiate better reimbursement rates and terms. Hospitals offer a wide range of services, not just mental health care, which diversifies their revenue streams and makes it more financially viable to absorb the lower reimbursement rates for mental health services. Many hospitals have financial assistance programs to help patients who cannot afford care, supported by charitable donations or government funding. By leveraging these advantages, hospitals can navigate the complexities of insurance reimbursement for mental health services more effectively than smaller, independent practices.

Will my insurance cover your services? 

Should you decide to submit claims to your insurance, a portion of the cost may be covered by your insurance. Plans vary in terms of what they will  cover for an out-of-network provider. We have seen some plans reimburse clients for as much as about  $100 per therapy session, whereas some plans provide no reimbursement or have very high out-of-network deductibles.  It is your responsibility to check with your insurance ahead of time so that you understand your coverage and avoid surprises.

Will you bill my insurance directly? 

We are not able to bill insurance directly. Instead, we provide you with documentation that you can  submit for out-of-network reimbursement. Your insurance will send the payment to you directly.  

I’m interested in your services, but I cannot afford the out-of-pocket costs. What are my options?

We understand that many families are simply not in the position to pay for out-of-network providers. Or, families might want to use in-network benefits insurance regardless of their ability to afford out-of-network services. In such cases, you might consider working directly with your insurance to find an in-network provider. If a patient needs to see a specialist who is not in their insurance network, they can request a benefits exception for the out-of-network provider to be covered.  We cannot speak to the success rates in receiving benefit exceptions, however. Please note that a benefits exception should not be confused with a single case agreement - we do not enter into these contracts with insurance.  

What billing codes will you be using?

Therapy / treatment codes may include one or more of the following*: 90791, 90834, 90846, 96137

*The “-95” modifier is added to the above codes if any of the services are delivered via telehealth.

Evaluation codes may include any of the following: 90791, 96130, 96131, 98132, 96133, 96136, 96137, 96138, 96139

How do I pay for your services? 

When you set up your account in our secure client portal, you will be asked to store a credit card. We process charges on the day of service.  

Can I use my HSA or FSA card? 

No, we are sorry. We have encountered too many obstacles posed by this payment source. However - our understanding is that you may be able to reimburse yourself from your HSA and FSA funds for costs incurred with us, assuming the services meet the criteria required by your HSA or FSA program for reimbursement.

When will you send me a form for me to submit to insurance?  

On the 5th of every month, our system generates a Superbill (that reflects the prior month’s services) that is emailed to you. 

If I get a Superbill, do I have to pay it? 

No. Superbills are autogenerated by the portal system. They reflect your payments so that you can submit the charges to your insurance.  

I’ve lost my Superbills. Can you send me a new one? 

Of course! We can recreate superbills for any time period, at your request. 

If I cancel my session, will I still get charged? 

We require 48 hour business day cancellation notice in order to avoid being charged for your scheduled  session. Please note that we may waive this fee on a case-by-case basis.