Embedded Files
Professional Fees
Individual Therapy
The standard fee for a 50 minute - individual therapy session is $200
The standard fee for a 50 minute - initial intake for individual therapy is $225
Sessions that exceed the standard duration will be billed prorated at $200 per hour
Consultation
I currently provide consultation services to individuals and organizations anywhere in the U.S. and other countries. Please contact me if you are interested in receiving more information.
Self-Pay Therapy Clients - Service Fees & Reduced Service Fee Options
I offer therapy services to self-pay clients through a Three-Tier service fee structure. This includes a standard service fee option, and reduced service fee options. My intention is to make therapy more inclusive and accessible for clients.
Choosing a Service Fee Tier: I encourage you to take an honest inventory of your current needs and financial situation to determine which tier best reflects your current circumstances and life experience. This process is trust-based, as I do not ask for any documentation or verification of income or expenses. We will discuss your choice, and agree on a Service Fee before establishing a Service Fee Agreement.
Service Fee Tiers Overview:
Tier 1: “Green Bottle Method” Service Fees
Who this tier is for: Clients who need ongoing therapy, and are either able to afford the standard rate, or experience some level of financial need.
Service Fee range: $140–$200 per session
Duration: 12 months
Availability: Open to all clients
Renewal: Renewable annually
Service Fee changes: Annual professional fee increases may apply at renewal
Tier 2: Reduced Service Fee ($110-$139)
Who this tier is for: Clients who need ongoing therapy, and experience more financial need and cannot currently afford the Tier 1 service fees.
Service Fee range: $110–$139 per session
Duration: 12 months
Availability: Limited slots
Renewal: Reviewed at the end of the Service Fee Agreement
Service Fee changes: Annual professional fee increases may apply at renewal
Tier 3: Reduced Service Fee ($1-109)
Who this tier is for: Clients experiencing significant financial hardship and who need Tier 3 reduced service fees as a form of short term support.
Service Fee range: $1–$109 per session
Starting Service Fee is negotiated
Service fee increases $10 every 10 sessions (max $109)
Duration: Short-term support, 6 months
Availability: Very limited slots
Renewal: Not renewable consecutively
*Please note that Tier 2 & 3 reduced service fees are based on financial need, clinical appropriateness, and clinician’s discretion. These reduced service fees have a specific duration, and the service fee may change or end after the specific duration. They have limited availability and are not guaranteed. In addition, participation in a Tier 2 or Tier 3 reduced service fee tier does not guarantee renewal or continuation at the same rate.
Tier Details
I. Tier 1: “Green Bottle Method” Service Fees
I offer all clients who self-pay for therapy services the option for “Green Bottle Method” Service Fees. The Service Fee Agreement is for 12 months, and it is renewable. The annual professional fee increase would apply at the time of renewal.
Service Fees & Descriptions (Summary):
Left Bottle: $200; client comfortably meets all their basic needs
Middle Bottle: $170; client generally meets basic needs with some stress
Right Bottle: $140; client may frequently struggle to meet their basic needs
“Please be mindful that if you [choose] […] at the lowest end of the scale when you can truthfully afford the higher [service fee] […], you are limiting access to those who truly need the gift of financial flexibility.”
“[Consider] the idea of sacrifice versus hardship when examining access. If paying for a […] service would be difficult, but not detrimental, it qualifies as a sacrifice. You might have to cut back on other spending in your life (such as going out to dinner, buying coffee, or a new outfit), but this will not have a long term harmful impact on your life. It is a sacred sacrifice in order to pursue something you are called to do. If, however, paying for a […] service would lead to a harmful impact on your life, such as not being able to put food on the table, pay rent, or pay for your transportation to get to work, then you are dealing with hardship. Folks coming from a space of hardship typically qualify for the lower end of the sliding scale.”
Statements written on the “Green Bottles” that describe a person’s possible economic situation (click on arrows):
Top of the Scale (or the left bottle):
I am comfortably able to meet all of my basic* needs
I may have some debt but it does not prohibit attainment of basic needs
I own my home or property OR I rent a higher-end property
I own or lease a car
I am employed or do not need to work to meet my needs
I have regular access to health care
I have access to financial savings
I have an expendable** income
I can always buy new items
I can afford an annual vacation or take time off
Middle of the Scale (or the middle bottle):
I may stress about meeting my basic needs but still regularly achieve them
I may have some debt but it does not prohibit attainment of basic needs
I own or lease a car
I am employed
I have access to health care
I might have access to financial savings
I have some expendable income
I am able to buy some new items & I thrift others
I can take a vacation annually or every few years without financial burden
Bottom of the Scale (or the right bottle):
I frequently stress about meeting basic needs & don’t always achieve them
I have debt and it sometimes prohibits me from meeting my basic needs
I rent lower-end properties or have unstable housing
I do not have a car and/or have limited access to a car but I am not always able to afford gas
I am unemployed or underemployed
I qualify for government assistance including food stamps & health care
I have no access to savings
I have no or very limited expendable income
I rarely buy new items because I am unable to afford them
I cannot afford a vacation or have the ability to take time off without financial burden
* Basic Needs include food, housing, health care, and transportation.
** Expendable Income might mean you are able to buy coffee or tea at a shop, go to the movies or a concert, buy new clothes, books, and similar items each month, etc.”
- Excerpts from the article “The Sliding Scale: A Tool of Economic Justice (aka The Green Bottle Method),” written by Alexis J. Cunningfolk. To learn more, please visit: http://www.wortsandcunning.com/blog/sliding-scale.
II. Tier 2: Reduced Service Fee ($110-$139)
I reserve a limited amount of slots on my caseload to offer reduced service fees ranging from $110-$139 to clients who self-pay for therapy services. This tier provides ongoing care at a reduced-rate for clients experiencing financial hardship. The Service Fee Agreement is for 12 months, and may be renewed upon review. The annual professional fee increase would apply at the time of renewal.
III. Tier 3: Reduced Service Fee ($1-109)
I reserve a very limited amount of slots on my caseload to offer reduced service fees ranging from $1-$109 to clients who self-pay for therapy services. This tier provides short-term support for clients experiencing significant hardship. The Service Fee Agreement is for 6 months, and is not renewable consecutively.
Clients starting service fee is negotiated within the $1–$109 range. The Service fee increases by $10, after every 10 sessions, up to a maximum of $109.
At the end of the 6-months with Tier 3, clients may transition to:
At the end of the 6-months with Tier 3, clients may transition to:
Tier 1: $140–$200 per session, or
Tier 2: $110–$139 per session, if eligible, and clinician has caseload availability.
If a client feels that Tier 1 or Tier 2 service fees are unaffordable, therapy services will need to end, and the clinician will provide appropriate referrals or community resources to support continuity of care. Tier 3 may be offered again in the future, but cannot continue immediately after the initial 6-month duration.
If a client feels that Tier 1 or Tier 2 service fees are unaffordable, therapy services will need to end, and the clinician will provide appropriate referrals or community resources to support continuity of care. Tier 3 may be offered again in the future, but cannot continue immediately after the initial 6-month duration.
Tier 3 may be offered again in the future, but cannot continue immediately after the initial 6-month duration.
Tier 3 may be offered again in the future, but cannot continue immediately after the initial 6-month duration.
Non - Psychotherapy Professional Services & Fees:
Non-psychotherapy professional services are services provided outside of regular therapy sessions and are not therapy. These services are billed at $200 per hour, prorated in one-minute increments with a one-minute minimum ($3.33 per minute), unless otherwise agreed to in writing.
Non-psychotherapy professional services may include, but are not limited to: report writing, record review, preparation or release of records or treatment summaries, or other documentation, meetings, consultations, or communications requested by the client or a third party, telephone calls or email/text correspondence lasting longer than five minutes, or administrative or legal matters (e.g. court appearances, subpoenas, depositions, etc), and other professional services requested outside of therapy. These services are generally not covered by insurance and are the responsibility of the requesting party. When reasonably possible, you will be informed in advance if a requested service is likely to result in additional fees.
Professional Fee Raises
My professional fees for my private practice will be increase annually by 5% on January 1st. This includes psychotherapy and non-psychtherapy service fees. I reserve the right to adjust my fees at any time. You will be notified at least 30 days in advance of any fee increase. Existing Service Fee Agreement remains in effect for the agreed-upon services and fees, unless replaced by a new agreement.
Service Fee Agreement: Self-pay clients will receive a separate Service Fee Agreement via the Electronic Health Record (EHR) system for review and signature. This agreement outlines services provided, service fees, and payment terms. For psychotherapy, it would also outline session frequency and/or duration. A new Service Fee Agreement will be provided if any of the above mentioned terms change. When a new SFA agreement is issued, clients will receive a Good Faith Estimate and No Surprises Act notice, as required by law.
Cancellations & Missed Telehealth Appointments
I have a strict policy regarding cancellations, & missed Telehealth appointments. I ask clients to reschedule, or cancel at least 48 hours in advance.
Late Cancellations (<48) or missed appointments (“No Shows”) are charged a $125 cancellation fee, unless we both agree that you were unable to attend due to circumstances beyond your control (i.e. sudden illness, accident, emergencies, etc). This fee is the client’s responsibility and is not covered by insurance.
A valid payment method must remain on file in the Electronic Health Record (EHR) system to cover cancellation/no-show fees. If your regular session fee is less than $125, your cancellation fee will match your regular session fee.
Billing and Payments
You can learn more about all the treatment payment methods available by reading below (click on the arrows):
Self-Pay Clients
Acceptable payment methods include: checks, and all major credit, debit, FSA, and HSA cards. Please make all checks payable to: Melissa Pérez. A $10.00 service charge will be charged for any checks returned for any reason for special handling.
Payments for Telehealth sessions are processed through the Electronic Health Record (EHR) system, a secure and HIPAA-compliant platform. Payment for a Telehealth session is expected at the time services are rendered. Payment schedules for other professional services will be agreed upon as they are requested. Please ask me if you wish to discuss a written agreement that specifies an alternative payment procedure.
Good Faith Estimate and the “No Surprises” Notice: Self-pay clients will be provided with a Good Faith Estimate and a “No Suprises” notice. The Good Faith Estimate explains how much your care will cost. Under the law, health care providers need to give clients who don’t have insurance or are not using insurance (including clients who pay out-of pocket and request insurance reimbursement) an estimate of the bill for medical items and services (including psychotherapy). You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services, including psychotherapy services. The “No Surprises” notice reviews these client rights.
Insurance - In Network Provider
I currently only accept the Lyra Health insurance plan in my private practice for individual therapy.
Please note that you are responsible for payment of your therapy service fees, regardless of whether or not they are covered by your insurance. If you are using your insurance benefits, please note that certain professional services outside of your presenting problems, such as medical record preparation requests, and participation in legal proceedings, may be outside the services paid for by your insurance or sponsoring employer and may incur you additional service fees. Any additional service fees will be discussed and agreed upon when they are requested.
If you are using the Lyra Health insurance plan, please note that the fees for your sessions will be paid for by your sponsoring employer as long as you are eligible, subject to any limits under your benefit plan, and as long as sessions are considered clinically appropriate.
Insurance - Out-of-Network Provider
If you have an insurance plan not listed above, there is a possibility that I may be considered an out-of-network provider. This is primarily for individuals with Preferred Provider Organization Plan (PPO) insurance.
A client would pay the full fee of $200 per 50 minute session at the time of service. I would provide them with a monthly superbill, and then they would be responsible for processing their claim for direct reimbursement with their insurance company. The rate for reimbursement would depend on your insurance plan and out-of-network benefits, and would most likely be a partial reimbursement.
Please note that some insurance policies have a deductible that clients must meet before being eligible for reimbursement. I recommend you speak with your insurance and ask clarifying questions about your insurance plan, and the reimbursement rate and deductible for mental health care for out-of-network providers.
Some helpful questions to ask your insurance provider before our first appointment:
Do I have out-of-network mental/behavioral health benefits?
Do I have an out-of-network deductible that has to be met first before I get reimbursed? Has any amount of my deductible been covered this year?
How much would I get reimbursed?
What is the usual and customary rate covered by my insurance for outpatient psychotherapy (CPT code 90834) (This is a specific code insurances use for billing)?
Is approval or pre-authorization required?
Is there a limit to the amount of sessions I can have in a year?
How do I submit claim forms for reimbursement?
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