Everything related to Fees

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For my weekly clients (not intensive clients): my practice offers a tiered, class-equitable, pay-what-supports-you pricing.

This pricing structure is reflective of the cost per 50 minute session per individual/couple and for folx that are cash pay only.

Please keep in mind that if you opt into a lower price, when you can truly afford a higher price, you are limiting access to those who truly need the gift of financial flexibility. If participating in therapy means making short term sacrifices, having to get creative or asking others for support and does not actually jeopardize your safety, we ask you to use those resources before using the sliding scale. This will limit opportunities for others. Being honest and taking the time to explore your options financially helps us grow in this healing work together. 

I currently have limited virtual openings for individuals living in the State of Washington. Preference will be given to those who are specifically interested in IFS therapy, but open to those who want a more "traditional" approach to talk therapy. All sessions are offered virtually and on a weekly basis (no monthly or bi monthly options are available). 

This model is inspired by the “Green Bottle” framework created by Alexis J. Cunningfolk (www.wortsandcunning.com) with modifications by Britt Hawthorne (www.embracingequity.org).

  • Redistribution- $600 per hour

    I can easily cover all my essential expenses, including food, housing, and transportation, without financial strain. Any financial stress I experience is unrelated to meeting these basic needs.


    Any debt I have does not prevent me from covering essentials.


    I have stable employment, or I am a stay-at-home caregiver by choice with a partner who is securely employed, or I do not need to work to maintain my lifestyle.


    I live in a home that is comfortable, well-equipped, and spacious enough for my needs.


    I own or lease a car and have the option to replace it with a newer model every few years if I choose.


    I have reliable access to healthcare whenever necessary.


    I maintain savings that I can draw from when needed.


    I can purchase new items as desired.


    I generally have extra income to spend on luxuries and indulgences.


    I’m typically able to choose higher-quality or premium products when I prefer them.

  • Full Cost- $500 per hour

    Financially, I consistently cover my basic needs, including food, housing, and transportation, with ease. Any financial stress I experience is typically unrelated to these essentials.


    Any debt I have does not interfere with meeting my basic needs.


    I have stable employment, or I am a stay-at-home caregiver who chooses not to work outside the home, supported by a partner with steady employment.


    I live in a home that is comfortable, adequately spacious, and equipped with modern amenities.


    I own or lease a vehicle and can afford its upkeep, or I have chosen a car-free lifestyle.


    I generally have access to healthcare when I need it.


    I might have some savings available to use during times of financial need.
    I can often buy new items, although larger purchases may require some planning.


    I occasionally have discretionary income, allowing me to enjoy small luxuries or indulgences each month.


    With planning, I can take a vacation every year or two.

  • Solidarity- TBD

    Financially, I often struggle to meet my basic needs, such as food, housing, and transportation, and I frequently feel stress about covering these essentials.
    I may have debt that occasionally prevents me from meeting these needs.


    I am unemployed, underemployed, or concerned about my income or the stability of my job.


    My housing situation may lack space, comfort, modern conveniences, or stability.


    I do not own a car by choice, have limited access to one, or cannot consistently afford gas.


    I do not always have access to the healthcare services I need.


    I lack savings to rely on when funds are low.


    I seldom buy new items and often have to go without.


    Discretionary income for indulgences, like new clothes or entertainment, is not typically available to me.


    Vacations are generally unaffordable, and taking time off work is a financial strain or poses a risk to my job security.


    I qualify for and may rely on some form of public assistance.

Fees

  • Payments are accepted via FSA, HSA or credit cards

  • The full rate is $500/50 minute session

  • Fee transparency: My fees reflect my personal and professional experiences, trainings, education, costs of running a business, travel expenses for trainings, health insurance, costs of living in Seattle for a household of 5, licensing and tax costs, personal care management and certifications/continuing education costs.

    • I am most effective as a therapist when I take care of myself financially and emotionally. My rates are a reflection of a desire to see less clients per week so that every client that I do see is getting exquisite care.

  • Mutual Cancellation Policy: Your time is just as valuable as my time. I have a 48-hour cancellation policy, with the exception of any emergencies. Being busy at work, forgetting about a session, and/or running late does not constitute an emergency. If you cancel your session after 48-hours, you will be charged the full fee. If I cancel within 48-hours and it’s not due to illness or emergency, your next session is waived/free.

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Insurance Coverage

I do not accept any form of health insurance, but can provide a monthly receipt for you to submit to insurance if you have out of network (OON) benefits.

  • If you have PPO insurance that offers OON benefits, you may receive 30%-40% reimbursement after meeting your OON deductible but that is not guaranteed.

  • HMO plans don’t offer OON benefits.

  • I’ve partnered with Thrizer for folx who wish to use their out of network health insurance benefits

Out of Network Calculator

If you aren’t sure of your out of network deductible or coverage, feel free to use this calculator to estimate your potential coverage: https://calculator.meetnirvana.com

FAQs

  • • Accepting insurance would mean that I would have to see more clients per week in order to meet my income goals. This is a recipe for burn out and it is not sustainable for myself or my family.

    • Cost of living is too high in Seattle

    • The amount of paperwork required to process insurance payments would be around 8-12 hours a week, on top of seeing clients. I don’t have the capacity to do so.

    • Insurance companies don’t pay therapists a sustainable rate

    • Insurance doesn’t pay therapist when a client no-shows or misses a session

    • There are limits to what practices we can do if we are working within the limits of insurance—different modalities are not allowed, such as psychedelic assisted therapy and some “non evidence based” modalities.

    • They create a paper trail that requires you to document a diagnosis, which can eventually cause your life insurance to be declined, mortgage loans to be denied or affect your future employment status.

    • It requires documentation of medical necessity

  • • Reimbursify will submit the insurance reimbursement paperwork for you. The first claim is free, and then they charge $2.99 per claim.

    • The Superbill charges 2.9% of your reimbursement.

    • Meet Nirvana will provide you an estimate of your possible reimbursement. See calculator above.

    • My clients value their privacy. When you submit paperwork to insurance, you also give up a sense of privacy since the therapist has to disclose a diagnosis, possibly treatment plans and progress reports.

      • No limits to the number of sessions you get to have

      • No restrictions for modality of treatment (some like to incorporate psychedelics and all insurances do not accept psychedelic assisted therapy as a form of therapy)

      • No diagnosis on your record

      • Wanting a quick and easy access to seeing a therapist (instead of waiting on a long waitlist for an insurance therapist)

      • More customization with treatment

      • Therapist may be working with a smaller caseload and may have more time and energy to spend with you

  • • Beginning January 1, 2022, federal law requires health care practitioners to provide current and potential clients who don’t have insurance or who are not using insurance a “Good Faith Estimate” (GFE) on the cost of treatment.

    • This new law is designed to provide transparency to clients regarding their expected medical expenses and to protect them from surprises when they receive their medical bills.

    • You may prefer finding a therapist who accepts insurance rather than paying cash/out of pocket.

    • If you’re seeking weekly therapy, you can expect to pay $1,100 per month.

  • • Call the number on the back of your insurance card

    • HMO plans do not typically offer OON benefits

    • PPO plans typically do

  • • Do I have mental health insurance benefits?

    • Do my benefits cover telehealth/online therapy services?

    • Does my plan cover out-of-network (OON) providers?

    • Do I have a restricted number of visits per year for mental health counseling? If yes, how many visits?

    • Will I be reimbursed for seeing a licensed mental health counselor (LMHC)?

    • How much of the fee is reimbursed for OON master’s level providers for the following services: 60-minutes: 90837

    • What is your usual and customary reimbursement rate for CPT codes 90837 in zip code 98108?

    • What is my deductible for OON benefits? Have I met my deductible for OON benefits?

    • Are there any differences between billed charges and allowed charges when the service provider is OON?

    • What documentation do I need to submit to receive OON therapy reimbursements for OON providers (documentation, diagnosis, provider NPI number, etc.)?

    • How long will it take to be reimbursed for sessions after I have submitted my claims for out-of-network benefits?

    • Is approval required from my primary care physician or do I need a referral from an in-network provider?

    • (For couples counseling). Will Z Code “Z63.0, Relationship Distress With Spouse or Intimate Partner” be reimbursed?

    Remember to document the conversation

  • CPT code- 60-minutes: 90837 ($275)

    License #: LH60907817 (LMHC)

    Telehealth Services (inquire if your insurance covers teletherapy)

    Diagnosis: This will be discussed during our first 1-3 sessions.

    NPI number: 1831527746

  • No, because I really like to keep my “pay what you can” offerings to folx who are cash pay and don’t have access to OON benefits.

    If you do have OON benefits and want to use it, I will provide you with a monthly superbill with everything you need to submit to your insurance for possible reimbursement. Please let me know sooner rather than later if you plan on using your OON benefits so I can be sure to send the proper documents.