Tranquil Minds Counseling Service Charges

This notice went into effect on March 21, 2025

It is highly recommended that you contact your insurance company prior to starting services in order to ensure coverage, receive prior authorization if needed, and/or obtain information regarding limits to your coverage for mental/behavioral health services. This will help to prevent any surprises in your bill.

• Payment for services may be made via check, debit/credit, or HSA/FSA. We do not accept cash payment.
• Any portion of the bill not covered by your insurance company will be your responsibility.
• All copays will be due at the time of service.
• If paying out of pocket, payment is due at the time of service.
• If a claim is denied or not covered in full by your insurance company, you will receive an invoice/bill from Tranquil Minds via SimplePractice and you may pay this by check or through the online payment system (Stripe).
• You have the option to save a credit card on file, and by doing so, acknowledge that you are agreeing to allow Tranquil Minds to charge your card for copays, uncovered portions of your services, and/or missed session fees. Effort will be made to contact you prior to charging your card.
• A $20.00 service charge will be charged for any checks returned for any reason for special handling.

Below is a list of the session codes and cost for each type of therapy provided. If you do not have insurance or are not covered by one of the insurance companies contracted with Tranquil Minds Counseling, this will be the out of pocket cost. If you are unable to afford this cost and are not insured by one of the insurance companies contracted with Tranquil Minds Counseling, you may request a sliding scale fee, which will be determined between the provider and the client based on the client’s financial abilities and circumstances. Not all clients that request sliding scale will be provided an alternate cost, as this will be determined on a case-by-case basis.

60 Minute Psychotherapy Intake Session (90791 CPT code): $200.00

60 Minute Psychotherapy Session (90837 CPT code): $175.00

45 Minute Psychotherapy Session (90834 CPT code): $145.00

30 Minute Psychotherapy Session (90832 CPT code): $100.00

60 Minute Family Psychotherapy with Patient Present (90847 CPT code): $150.00

60 Minute Family Psychotherapy with Patient not Present (90846 CPT code): $125.00

60 Minute Group Therapy Session (90853 CPT code): $40.00

Under Section 2799B-6 of the Public Health Service Act ("No Surprises Act"), health care providers are required to provide a good faith estimate of expected charges for services to individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage, both orally and in writing, upon request or at the time of scheduling health care items and services.

If you are choosing to self-pay for services with Tranquil Minds Counseling, we will provide you with a Good Faith Estimate prior to your appointment. This Good Faith Estimate shows the costs of items and services that are reasonably expected for your mental health care needs for an item or service. The estimate is based on information known at the time the estimate was created. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.

Disputing a Bill from a Good Faith Estimate

If you are billed for more than your Good Faith Estimate, you have the right to dispute the bill.

Please contact Tranquil Minds Counseling to let us know the billed charges are higher than the Good Faith Estimate. You can ask us to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.

You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price stated on your Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount. To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call 1-877-696-6775.

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 1-877-696-6775.