The practice offers a range of fee rates to meet a variety of needs. Standard rate for individual & couples psychotherapy services is $200 for Spiegel and $125 for Dodes and Krigel. Additionally, each clinician offers a sliding fee scale of up to 35% off the standard rate in cases of financial need. Thus, if you qualify, it may be possible to meet with a clinician for individual services for under $100/session. We also offer group psychotherapy at $70/session, with a sliding fee scale down to $50/session. In the sections that follow, we describe our services, rates, and insurance participation in greater detail.
"Insurance Friendly" Practice
We are an "insurance friendly" practice. What does this mean? It means that while I am an out-of-network provider with all plans except one (see below), I will be happy to provide you with detailed invoices that you can submit to your insurance company for subsequent reimbursement after each session (payment is due at time of service). In my experience, I have found that it is often possible to receive moderate out-of-network reimbursement from your insurance company so long as you have a PPO or POS plan. The reimbursement rates vary highly by plan, but usually run anywhere from 33 to 75 percent. In addition to supplying you with invoices, I am willing to help you navigate the insurance process by counseling you on appropriate questions to ask your insurance company regarding treatment and reimbursement.
Why don't I directly participate with most insurance companies?
- Confidentiality -an insurance company can require the submission of sensitive treatment information from in-network providers, and I have no assurance that this information will be protected with the utmost of confidentiality once it is received by that company. By working out-of-network, I can better protect your privacy.
- Treatment Management -an insurance company has the option of restricting treatment due to directives that may not match the client's needs. Examples would include the length of treatment or the type of treatment used. By taking the insurance company out as the middleman, I am able to work with you collaboratively in setting the direction of your treatment.
- Time - Because psychologists are unlike doctors in that they see only one patient per clinical hour (e.g. a 45 minute session), and the visits are one-on-one (unless the modality is couples or group psychotherapy), those who choose to work as in-network providers with multiple companies must cram their schedules with large patient loads in order to compensate for the low provider reimbursement rates which are part of being an in-network participating provider. I reject this model because I believe that it is clinically and ethically important to be thoroughly prepared and "fresh" for each client that I see. This allows me to offer the highest-quality services possible. I can also save the time that would be used for insurance company calls and paperwork and instead devote it to client care.
More information on my rates and insurance participation is offered below.
Payment Information for Individual & Couples Psychotherapy; Clinical Hypnosis
Out-of-Network (self-pay): My standard fee is $200 for a 50-minute session. In addition, I have a sliding fee scale of up to 35% for clients who qualify. This sliding scale is based on household income, number of persons in the household, and supplemental income. I maintain several sliding scale time slots on my schedule per week. My ability to offer a sliding scale to potential clients is based on meeting the above factors, as well as availability in the schedule. Please contact me for more information if you are interested in exploring whether you qualify for the sliding scale.
- Josh Dodes, LCSW: Standard fee is $125 for a 50 minute session; a sliding scale of up to 35% is available for clients who qualify.
- Jon Krigel, PsyD: Standard fee is $125 for a 50 minute session; a sliding scale of up to 35% is available for clients who qualify.
Keep in mind that you may be able to receive out-of-network insurance reimbursement from your insurance plan. With many PPO plans, it is possible to send in an invoice post-session to receive partial reimbursement from your insurance.
Highmark Blue Shield: I participate with Highmark Blue Shield’s Premier Blue PPO program. I am in-network with Highmark and other affiliated Blue Cross/Blue Shield PPO plans. This includes Federal and some out-of-area BCBS PPOs. It does NOT include POS or HMO plans. Please check directly with your plan to determine benefits and coverage (e.g. co-pay, pre-authorization, session limits).
Please note: It is important to check directly with your Blue plan regarding my participation. Some Blue plans may have "carve outs" of mental health benefits to another independent company. In such instances, I may not participate with the company managing the mental health benefits for your Blue plan, effectively rendering me as a non-participating out-of-network provider. This may exist for specific plans within a Blue company, so it is important to check. Independence Blue Cross outsources all of their mental health benefits to a company, Magellan, with whom I do NOT participate. Therefore, I do not participate with any of Independence’s plans, including Personal Choice PPO and Keystone East HMO. If you have one of these plans, I am considered an out-of-network provider. You can see me as a self-pay client (see above), and then submit your claims for reimbursement from your insurance company. This is contingent upon your out-of-network benefits.
Payment Information for Group Psychotherapy
My fee for a group psychotherapy session varies, depending upon the length (60-75-90 minutes) of the group. Usually the fee runs between $50-$70/session. A limited sliding scale may be available, depending upon the group and availability. Contact me for more information. Highmark Blue Shield subscribers may be eligible for in-network group psychotherapy rates. This is contingent upon the benefits of your plan. For all clients, I require an individual initial intake session (see above for more information) prior to participating in a group.