Rates and Insurance

Fees

Payment is due at the time service is rendered. Fees are based on the service provided, your insurance coverage, and the length of the sessions.

Rates

For those clients choosing to pay out-of-pocket, either due to lack of mental health coverage or to maintain confidentiality from insurance companies, the out-of-pocket cost for a one-hour initial consultation session is $275 and subsequent 55-minute therapy sessions are $225.

Insurance

Dr. Martinez is an in-network provider with the following insurance plans:

  • Aetna

  • First Choice Health

  • Lifewise

  • Lyra Health

  • Premera Blue Cross

  • Regence Blue Shield

Dr. Martinez is an out-of-network provider for the following insurance plans:

  • Kaiser Permanente

  • Optum

  • United Healthcare

If your insurance company offers out-of-network benefits, you may receive full or partial reimbursement for the cost of services. Most insurance companies that provide out-of-network benefits cover between 50%-80% of the cost per session. Dr. Martinez will provide statements for clients to submit to the insurance company so that they can be reimbursed directly. She will also provide information to the insurance company, should they request it, to facilitate reimbursement, with the client’s written permission.

Please verify your benefits before your initial appointment. Most insurance plans require some patient portion, such as amounts working toward deductibles, co-payments or co-insurances.

Determining Insurance Benefits

Please contact your insurance provider directly to verify if Dr. Martinez is in-network with your specific plan and to determine your mental health coverage prior to your initial appointment. In order to determine what your benefits are, call the customer service number for Behavioral Health on the back of your insurance card and ask the following questions:

  • Do I have behavioral health coverage?

  • Determine if Dr. Martinez is an in-network or out-of-network provider for your specific plan.

  • If Dr. Martinez is in-network, what is my copay or coinsurance for an outpatient mental health office visit?

  • If Dr. Martinez is out-of-network, do I have out-of-network mental health benefits?

  • What amount will I be reimbursed for the following services by a licensed clinical psychologist?

    • CPT code 90791 (initial assessment)

    • CPT code 98037 (individual psychotherapy)

  • Is pre-authorization required? If so, what information do I need for this? Is there a specific form that needs to be completed?

  • Is there an annual deductible I need to meet before I can begin receiving reimbursement for sessions?

  • Do I have to pay a copay or coinsurance amount?

Good Faith Estimate (No Surprises Act)

​You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.​

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

  • Make sure to save a copy or picture of your Good Faith Estimate.

 For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

 

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