Insurance & Fees

The providers at the CAPSS offices each have their own independent private practices and, as such, they each manage their own schedule, availability, fees, and insurance panels.

Fees

As independent practices, each provider’s fees are specific to their practice. Generally, therapy appointments are over $200 per 50-minute session. Comprehensive evaluations typically range from $2500-$5000 depending on complexity and type of evaluation.

Insurance

Most of the providers at CAPSS are not paneled with any insurance companies, and are considered “Out-of-Network” (OON) providers. None of our providers are contracted with state-sponsored insurance plans such as Medicaid (Apple Health, Molina, etc.) or Medicare. You can read each provider’s individual webpage for details on which insurances, if any, they accept in their practice.

You may be eligible for some reimbursement for OON services from your insurance plan. OON coverage is unique to each insurance company and plan. We encourage you to contact your insurer to inquire about your OON benefits for services and suggest gathering the following information, also available on this handout.

  • Do I have Out-of-Network coverage?

  •  What are my Out-of-Network benefits?

  • What is my deductible?

  • After I meet my deductible, what percentage of the visit cost will I be reimbursed for?

  • Will Telehealth services be reimbursed by my plan?

Services are billed using Current Procedural Terminology (CPT) codes.

Common assessment CPT codes we bill:

  • 90791 (intake appointment)

  • 96136 and 96137 (psychological test administration and scoring codes)

  • 96130 and 96131 (psychological evaluation services, including interpretation, report writing, and feedback appointment)

  • 96132 and 96133 (neuropsychological evaluation services, including interpretation, report writing, and feedback appointment)

Common therapy CPT codes we bill:

  • 90791 (intake appointment)

  • 90832 (individual therapy 16-38 minutes)

  • 90834 (individual therapy 39-52 minutes)

  • 90837 (individual therapy 53+ minutes)

  • 90846 (parent session without child present)

  • 90847 (parent session with child present)

Many families also use their FSA or HSA accounts to pay for medically-necessary services at CAPSS (e.g., comprehensive evaluations, and individual and group therapy; note that standalone IQ testing for school admissions is not typically reimbursed by insurance or by HSA/ FSA accounts due to it being educational in nature rather than medically-necessary).

Your individual provider can assist you with any additional information about their specific services and billing practices.