Fees and Insurance
Our practice is out-of-network with all insurance plans. Patients pay at the time of their visit, and we provide a detailed itemized receipt (superbill) that you may submit to your insurer for potential out-of-network reimbursement.
Why we are out-of-network
Operating outside insurance networks allows us to prioritize high-quality, individualized psychiatric care without administrative limitations.
More time with your psychiatrist
Initial evaluations are 60 minutes with a physician, and follow-up visits are scheduled according to what we need to cover. Reimbursement rates for psychiatry are low enough that in-network practices often cannot offer that flexibility.
Care that is not time-limited
Treatment continues as long as it is clinically appropriate. We are not working against a fixed number of authorized visits or a plan’s expectation of when treatment should conclude.
Continuity of care
You see the same psychiatrist at each visit rather than a rotating panel of prescribers. If another provider here becomes a better fit for you, we can transfer your care within the practice and your history stays with us.
Faster Access
New patient evaluations are typically available within one to two weeks, avoiding the months-long waitlists common in traditional insurance panels.
Physician-led care
Every psychiatrist in the practice is a physician with specialized psychiatric training. We have psychiatrists fellowship-trained in child and adolescent psychiatry.
You can read what our patients say on our patient reviews, parent reviews, and healthcare provider reviews pages.
Our Fees
All fees are due at the time of service. We provide an itemized receipt after every visit for insurance reimbursement.
Psychiatric evaluations
| Service | Length | Fees |
| Adult Psychiatric Evaluation | Up to 60 minutes | $500 |
| Child and Adolescent Psychiatric Evaluation | Up to 60 minutes | $500 |
| All ADHD Evaluations | Up to 60 minutes | $500 |
Your first visit is a full hour with our psychiatrist. We collect a detailed history of your symptoms, your medical and psychiatric background, and any other relevant factors so we can reach an accurate diagnosis and build a treatment plan.
Follow-up appointments
| Length | Fee |
| Up to 25 minutes | $315 |
| Up to 45 minutes | $420 |
Follow-up visits are where ongoing medication management takes place. Your psychiatrist will determine the appropriate visit length based on your treatment.
Brief 15-minute visits are reserved for established patients whose symptoms are well controlled and who have been stable on their current medication for some time. Your psychiatrist will advise you when this shorter visit is clinically appropriate.
Follow-up appointments are available in person at our Red Bank office or by telehealth throughout New Jersey. Fees are identical for both.
Therapy
| Service | Length | Fees |
| Therapy Evaluation | 50 minutes | $180 |
| On-going Therapy Sessions | 50 minutes | $180 |
Talk therapy is provided by the licensed clinical social workers in our practice, Monique Santone, LCSW and Danielle Ruchaevsky, LCSW.
Executive Function Coaching
| Length | Fee |
| 45 minutes | $150 |
Executive function coaching with Ken Erb supports organization, time management, planning, and follow-through. It is often used alongside psychiatric treatment for ADHD.
What you would actually pay
The sticker price is not what most insured patients end up paying. Here is how it works in practice.
Example. Your plan covers 70% of out-of-network mental health care after your deductible is met.
You pay us $500 for your evaluation at the time of the visit. You submit the receipt to your insurer. Your insurer reimburses you $350.
Your effective cost: about $150.
The same math applies to every follow-up. A $315 follow-up reimbursed at 70% costs you roughly $95 out of pocket.
Reimbursement rates vary by plan. We most commonly see 50% to 80% for out-of-network outpatient psychiatry once the deductible is met.
Reimbursement amounts are determined by your insurance plan, not by our office. This example is illustrative and is not a guarantee of coverage.
How reimbursement works
A simple three-step process to receive reimbursement after your visit.
We send your receipt
Your itemized receipt, also called a superbill, arrives automatically through the patient portal after each visit.
You submit it
Most insurers allow you to upload the superbill directly through their mobile app or member portal in a few clicks.
Your insurer reimburses you
Timing varies by plan, but reimbursement checks or direct deposits commonly arrive within two to six weeks.
Find out what your plan covers in one phone call
Call the member services number on the back of your insurance card and ask these five questions. Write the answers down.
1. “Do I have out-of-network outpatient mental health benefits?” If your plan does not include out-of-network coverage, you would be responsible for the full fee.
2. “What is my out-of-network deductible, and how much of it have I met this year?” Reimbursement usually does not begin until this is met. If you are late in the plan year and have already met it, you may be reimbursed starting with your first visit.
3. “Once my deductible is met, what percentage do you reimburse for out-of-network outpatient psychiatry?” Ask about the specific CPT codes
- Psychiatric evaluation: 90792
- Follow-up visits: 99213, 99214, and 99215
- Talk therapy: 90837
4. “Is there a limit on the number of visits you will cover per year?”
5. “How do I submit an out-of-network claim, and how long does reimbursement take?”Most plans now accept a photo uploaded through their mobile app.
Make a note of the representative’s name and the call reference number for your records.
Payment
Payment is due at the time of each visit.
Accepted methods
We accept all major credit and debit cards, HSA and FSA cards, Zelle, Venmo, and personal checks.
Save on follow-up visits
5% off
Pay for any follow-up appointment by Zelle or Venmo and receive 5% off that visit.
The discount applies to follow-up appointments only and does not apply to initial evaluations.
Common questions
If your plan does not include out-of-network coverage, you would be responsible for the full fee at the time of service. It may be worth reviewing your coverage at your next enrollment period. Employer-sponsored plans typically enroll in October or November, and individual plans through Get Covered New Jersey open November 1. Outside those windows, changes generally require a qualifying life event such as marriage, the birth of a child, a move, or a loss of coverage. If you would like to be reimbursed for care at our practice, look for a PPO or POS plan, as out-of-network benefits are uncommon in HMO and EPO plans. Your employer's benefits administrator or a licensed insurance broker can help you compare the options.
We are out-of-network with both. Traditional Medicare and Medicaid do not reimburse patients for care received outside their networks, so those plans on their own will not cover visits at our practice. Coverage can differ if you have additional insurance. Some Medicare Advantage plans and some secondary or retiree plans include out-of-network benefits that may reimburse part of the cost. If you have coverage beyond traditional Medicare or Medicaid, it is worth checking your out-of-network mental health benefits directly with that plan, and our team can point you to the questions to ask.
Yes. You can pay for visits directly with your HSA or FSA card at the time of service. Psychiatric evaluations, follow-up visits, and therapy are qualified medical expenses, though we recommend confirming any specific requirements with your plan administrator.
No. Telehealth visits and in person appointments are billed at the same rates.
Processing varies by insurer, but most reimbursement payments or direct deposits are completed within two to six weeks after claim submission.
All visit fees are due in full at the time of your appointment.
