Fees / Insurance/ Medicare

My fee is $175/session. Sessions are 45 minutes. Recently the president of the American Psychological Association stated unequivocally that the standard psychotherapy session is 45 minutes. (This was in response to successful pressure during the last few years from third parties, like insurance companies, who demanded this revision/shortening of session lengths by revising uniformly as an industry the whole procedure code system and by no longer routinely accepting and paying for the previous standard 50 minute sessions.)
 
I cooperate with all insurance companies (including Medicare) to assist the patient/client in obtaining what financial assistance is available from their insurance company. However I require that the patient pay for my services at each session for any portion of the $175 fee which the insurance company is unlikely to pay.

However I cannot do this with Anthem Blue Cross PPO patients or MHN/Health Net PPO patients because I am "in their network" -which means that if I am to accept one of their patients I must accept a steep discount; I cannot accept extra copayment from the patient to bring the total I am paid to the level of my normal fee. I am contracted with Anthem Blue Cross to be a preferred provider, and therefore prospective patients are sometimes given my name as an available psychologist. This is particularly common with students at UCSC covered with student insurance, and with Google employees.

However I am required (by my contracts with Anthem Blue Cross and MHN/HealthNet) to take about a 40% discount of my usual fee (and with MHN/HealthNet about 30%) if I accept an Anthem Blue Cross PPO patient. I will occasionally accept such a patient if I have openings in my patient schedule, but in recent months I have been full and even have had to turn away prospective patients who are willing to pay my full fee. So for the time being it is unlikely that I will accept new Anthem Blue Cross PPO patients or MHN/HealthNet patients, or Medi-Cal patients; I will update this website when I am more available.

I accept Medicare patients who have a supplemental insurance policy. I enjoy working with Medicare patients and am a qualified Medicare provider. The three payments, 1)from Medicare, 2)from the supplemental carrier and 3)from a 20% copayment from the patient(which is $35 per session), add up to something just short of my normal fee.

I regret the confusion and complexity of all this insurance business and I regret the dysfunctional healthcare system which we have here in the United States, which results in patients often finding access to care very difficult, and which results in insurance companies executives, like the president of UnitedHealthcare, receiving obscene salaries/compensation like $20,000,000/year.