Professional Fees
Dr. Danda is an out of network provider. Professional fees are based on factors such as regional psychotherapy rates and experience. Rates are subject to change on a yearly basis.
Initial Appointment (90791) Flat fee of $350 for a 75-90 minute session. Includes structured, clinical interview, initial impressions, and treatment plan as well as initial treatment strategies if time allows.
Therapy Sessions: Most treatment plans are based on standard therapy sessions, which are 40-50 minutes long and are billed at a fee of $175. If less time (e.g., 20-35 minutes) is needed, the fee is pro-rated at $115. Session time is based on factors such as goals, progress, addressing interim issues, and tailoring each session to the individual.
Questionnaires, scoring, and report writing: Charged at the base rate of $230 per 60 min, pro-rated on the actual amount of time used, in 5-minute increments.
Parent Coaching or Consultation*: Sessions, phone calls, or emails are charged at the base rate of $230 per 60 min, pro-rated on the actual amount of time used, in 5-minute increments.
No Shows and Cancellations* without 24-hours’ notice will be subject to a $75 late cancellation or missed appointment fee.
Phone calls* to patients or school staff, physicians, etc., lasting longer than 10 minutes, and involving therapeutic intervention, will incur charges prorated in 5-minute increments at the base rate for therapy sessions (i.e., $230 per 60minutes). There is no charge for brief contacts lasting less than 10 minutes or calls related to scheduling or therapy homework purposes (e.g., pre-arranged check-in calls, and clarification of therapy assignments).
ADHD Evaluation: The ADHD evaluation consists of a diagnostic interview, up to 4 hours of general socio-emotional questionnaires, ADHD specific questionnaires as well as computerized and brief paper-pencil tests, a feedback session up to 60 minutes, and a written report. The cost of the evaluation averages about $1280. This evaluation does NOT include any IQ or achievement testing.
*Please note these charges are rarely reimbursed by insurance.
Payments
Payment is expected at the time of service and may be made by check, money order, cash, or credit card (Mastercard, Visa, Discover, or American Express). Returned checks or charges will incur an additional $35.00 fee, and ongoing unpaid balances may incur interest and/or collections charges.
Dr. Danda does not participate in insurance plans in order to maximize her ability to provide individualized services tailored to each client and maintain the highest level of confidentiality. Read Using Insurance to find more about how to obtain reimbursement from insurance companies if you have out of network benefits.
Note for children of divorced/separated children: The parent who brings the child is responsible for payment in full at the time of service. If the child attends a session without a parent, payment will need to be sent with the child or a credit card kept on file. In the case of separated or divorced parents where one parent is court-ordered to pay for services, a copy of this document (in its entirety) is required before this information can be used. Also in cases of separation/divorce where both parents have legal custody, both parents are required to sign the Separated/Divorced Parents Consent.
Using Insurance
Dr. Danda’s philosophy is that her commitment and time is best spent providing personalized services tailored to each client and situation rather than dictated by managed care. Her practice is strictly fee-for-service, which allows for more privacy and flexibility in treatment than participation in managed care. Although Dr. Danda does not participate in any insurance panels or bill insurance directly, she provides documentation that can be submitted to insurance for potential reimbursement based on your out-of-network benefits.
For most out-of-network plans, there is a deductible, followed by the insurance company covering a certain percentage of what the company deems "usual and customary." If you choose to submit the superbill to the insurance company, the insurance company will reimburse you directly according to your plan benefits. While many patients are successful in seeking reimbursement for at least a portion of their therapy fees, please remember that reimbursement is considered a matter between you and your insurance company. Always check with them directly for questions about your coverage.
You can use money from a health savings or flex account to pay for services. If insurance does not cover psychological services, then you may be eligible to deduct the cost of services on your tax return as a health-related expense (Please consult your accountant or tax return adviser for specific guidelines.).
Dr. Danda is not a covered provider for either Medicare or Medicaid. If you choose to work with Dr. Danda, you will forego use of these benefits and pay for each treatment session on a fee-for-service basis. Dr. Danda will not file claims for Medicare or Medicaid and you will not be eligible to independently file claims for the services that she provides.
Determining your mental health coverage
Call your insurance carrier by calling the number on the back of your card listed for mental health. Check your coverage carefully and find the answers to the following questions:
Ask if you have “out-of-network” benefits?
Is there a deductible that must be met first and how much is my deductible?
What is the coverage amount for the assessment and therapy sessions? Usually the insurance company reimburses a percentage of what it has deemed “usual and customary”. Typical CPT codes (updated as of Jan 1, 2013) used would include:
90791: Psychiatric diagnostic interview
90832: Psychotherapy, 30 minutes with patient and/or family member
90834: Psychotherapy, 45-50 minutes with patient and/or family member
90837: Psychotherapy, 60 minutes with patient and/or family member
90846: Family psychotherapy without the patient present
90847: Family psychotherapy with patient present.
How many therapy sessions does my plan cover?
Is approval required from my primary care physician?
What is the process for getting reimbursed for out of network services?
For therapy related to medical diagnosis, ask whether the insurance company covers Health and Behavior Codes, which may be filed under the medical or mental health portion of your insurance.
For some individuals, there may be a significant deductible on their mental health benefits for an in-network provider such that the cost to see an in-network provider is comparable to the cost for an out-of-network provider.