Insurances Accepted:

• Kaiser Permanente

• Premera Blue Cross

• Regence BlueShield

• Asuris Northwest Health

Good Faith Estimate for Health Care Services

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to provide a good faith estimate of expected charges for items and 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. This form may be used by the health care providers to inform individuals who are not enrolled in a plan or coverage or a Federal health care program (uninsured individuals), or individuals who are enrolled but not seeking to file a claim with their plan or coverage (self-pay individuals) of the expected charges they may be billed for receiving certain health care items and services.

Fee Schedule:

Billing Code                     Service                               Rate

• 90791               Intake Interview $180  

• 90837               Full Session (50min)               $150

• 90834               Partial Session (40 min)          $100

• 90832               Check-in Session(15+min)     $50

• 90839               Crisis Session (60 min)           $180

• 90840               Crisis Add-On (+30 min)       $90

• 00000               No-show/Late Cancellation $150

Financial need-based sliding scale available upon request*

Good faith estimate for services beginning January 1, 2023-December 31, 2023:

Short-term Therapy: Intake+11 Sessions:                      $1,830

Weekly Sessions: Intake + 50 Full Sessions:             $7,680

Bi-weekly Sessions: Intake + 25 Full Sessions:             $3,930

Monthly Sessions: Intake + 11 Full Sessions:             $1,830