Choosing private pay instead of insurance
Some people have health insurance and still decide to pay for psychiatric care on their own. Others have a plan I don't accept, or live in Florida or Oregon, where I see patients on a private pay basis only. This page explains why people choose private pay, what it costs, and what to weigh before deciding.
- Initial evaluation
- $360, about 60 minutes
- Follow-up visit
- $185, about 30 minutes
- Where
- Pennsylvania, New Jersey, Florida and Oregon, by secure video
- Booking
- Through my secure patient portal, not Headway
- Missed visits
- $150 without 24 hours' notice
Reasons people pay privately for psychiatric care
Paying privately is a personal decision. These are the reasons that come up most often.
Privacy
When insurance pays, the plan receives diagnosis codes and visit dates. With private pay, nothing is sent to an insurance company unless the patient chooses to submit a superbill.
A right under HIPAA
A person who pays in full out of pocket can ask a provider not to share that care with their health plan, and the provider must agree.
Fewer outside limits
No prior authorizations, visit caps or network rules. How often we meet and what we focus on are based on clinical need, not on what a plan will approve.
Clear prices up front
Fees are listed in advance, and every new private pay patient receives a Good Faith Estimate. There are no surprise bills from denied claims or deductibles.
Services insurance rarely covers
Private pay includes options such as psychedelic integration sessions, which most plans do not pay for.
Superbills, HSA and FSA
Superbills are available on request for out-of-network reimbursement, and visits are generally an eligible expense for HSA and FSA accounts.
Things to weigh
Private pay is not the right choice for everyone. A few practical points:
- Total cost. If a plan has a low copay for mental health visits, insurance will usually cost less. If a high deductible hasn't been met, visits may cost close to the plan's full rate until it is.
- Medications. Prescriptions can still be filled with insurance at the pharmacy, or at the pharmacy's cash price. Prescriptions for controlled medications are reported to the state prescription monitoring program either way.
- Lab work. Labs can be billed to insurance through Quest or Labcorp, or ordered at a cash price. GeneSight testing is billed by GeneSight directly.
- Reimbursement. A superbill does not guarantee payment, and submitting one shares the diagnosis and visit details with the plan.
If you have Medicare
I have opted out of Medicare. Medicare patients can be seen on a private pay basis after signing a private contract before the first visit. Medicare does not pay for these visits, and they cannot be submitted to Medicare for reimbursement.
How private pay is booked
Private pay visits are booked through my secure patient portal, not through Headway. Headway is used only for visits billed to insurance in Pennsylvania and New Jersey.
- A Good Faith Estimate of expected costs, in writing, before your first visit
- The right to dispute a bill that is at least $400 more than your estimate
- The right to ask that care you pay for in full not be shared with your health plan
- Access to your records on request
Getting started with private pay
Request a time
Choose an initial evaluation in my secure patient portal. A card is saved at booking, and I confirm the appointment after reviewing the request.
Forms and estimate
Intake forms and consents arrive by email through a secure client portal before the first visit, along with your Good Faith Estimate.
Meet by video
The evaluation is about 60 minutes by secure video. Follow-ups are about 30 minutes, and superbills are available on request.
Common questions about private pay
Why would someone choose not to use insurance for psychiatric care?
Common reasons are privacy, since nothing is sent to an insurance company; freedom from prior authorizations, visit limits and network rules; clear prices set in advance; and access to services insurance rarely covers. Some people also have a plan that isn't accepted, or live in a state where care is private pay only.
How do I book a private pay visit?
Through my secure patient portal. Choose an initial evaluation, save a card, and I confirm the appointment after reviewing the request. Private pay visits are not booked through Headway, which is only for visits billed to insurance.
Is anything shared with my insurance company if I pay privately?
No. When you pay privately, I do not bill your insurance or send it any information. If you choose to submit a superbill for reimbursement, your plan will see the diagnosis and visit details on it.
Can I get reimbursed by my insurance?
Some plans pay back part of the cost of out-of-network care. Superbills are available on request. Whether and how much your plan pays depends on your out-of-network benefits.
Can I use an HSA or FSA?
Psychiatric visits are generally an eligible expense for health savings and flexible spending accounts. Check with your plan administrator if you're unsure.
How much does private pay cost?
$360 for an initial psychiatric evaluation and $185 for a follow-up visit. Missed visits or cancellations with less than 24 hours' notice are $150.
Do you see patients who have Medicare?
Yes, on a private pay basis. I have opted out of Medicare, so Medicare patients sign a private contract before the first visit, and Medicare does not pay for or reimburse these visits.
Which states is private pay available in?
Pennsylvania, New Jersey, Florida and Oregon, by secure video. In Florida and Oregon, all care is private pay.
Book a private pay evaluation
Private pay is available by secure video in Pennsylvania, New Jersey, Florida and Oregon. For questions, call or text (215) 559-9962.