Insurance Reimbursement Therapy: Fees & Insurance Details

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We are in-network with the insurance coverage therapy plans listed below for services provided in Illinois only. Currently, we do not participate with Medicare, Medicaid, or HMO plans. If you are utilizing insurance coverage for therapy, please note the accepted in-network plans (Illinois Only): Aetna, Open Choice PPO, Open Choice POS II, and Blue Cross Blue Shield of Illinois for PPO plans only, including Blue Choice Options, Preferred, and Professional plans. If you reside outside of Illinois or are covered by a plan not listed above, our services will be considered out-of-network, and you may need to inquire about out-of-network reimbursement options for any therapy fees and payments.

If your insurance plan is not among those we participate with, you may still be able to use your out-of-network benefits for therapy services. After payment, we can provide a monthly superbill, which is an itemized statement of services that you may submit to your insurance carrier for possible reimbursement. 

We recommend contacting your insurance company before beginning treatment to verify your insurance coverage for therapy, out-of-network reimbursement options, eligibility requirements, and the reimbursement process. Please note that any requests for reimbursement are handled directly between you and your insurer. Walsh Behavioral Health Group PLLC does not participate in or manage insurance reimbursement claims on your behalf.

The following fees are for our most common therapy services: 

Diagnostic Evaluation (first session or re-evaluation; 55-Minute): $220 

Individual Therapy Session (55-Minute): $180 

Couple or Family Therapy Session (55-Minute): $220 

Group Therapy: $60 

Our therapy fees and payments are designed to be transparent. Please note that while we strive to provide the best support, all services are subject to your insurance coverage. If you are seeking out-of-network reimbursement, please make sure to discuss this with your provider.

Appointment Cancellation Policy: 

Your scheduled appointment time is reserved specifically for you. If you need to cancel or reschedule an appointment, please notify your provider at least 24 hours in advance by phone, email, or through the client portal.

Appointments canceled with less than 24 hours' notice, as well as missed appointments without prior notification, incur a $100 cancellation fee. Please remember that insurance plans do not reimburse for missed or canceled therapy sessions, making this fee the client's responsibility and not billable to insurance.

While we are happy to assist you in understanding your insurance coverage for therapy, please note that any information we provide regarding coverage, eligibility, or estimated costs should be considered informational only. Final payment determinations are made solely by your insurance carrier and are not guaranteed in advance.

For clients enrolled in one of our accepted insurance plans, we will submit claims directly to your insurer following each appointment. You will remain responsible for any applicable deductibles, copayments, coinsurance amounts, or other patient obligations required by your policy, including any out-of-network reimbursement issues that may arise.

Since insurance companies review and adjudicate claims after services have been provided, decisions about insurance coverage for therapy are ultimately made once the claim has been processed. Any portion of the therapy fees and payments that is not covered by your insurance plan will be your financial responsibility.

For your convenience, we accept major credit and debit cards, HSA and FSA cards, personal checks, and cash payments. To maintain a secure and efficient billing process, all clients are required to keep a valid credit or debit card on file, which ensures a smooth handling of therapy fees and payments. 

Unless alternative arrangements have been made in advance, the payment method on file will be charged following each appointment or after your insurance claim has been processed and any patient responsibility has been determined regarding your insurance coverage for therapy.

Please note that if your insurance carrier denies coverage for a service, you will be responsible for the full cost of the session. Any unpaid balances related to therapy fees remain the financial responsibility of the client and may not be eligible for out-of-network reimbursement.

If you do not have health insurance coverage for therapy or choose not to utilize your insurance benefits for non-emergency services, you may be entitled to receive a Good Faith Estimate under the federal No Surprises Act. This estimate outlines the anticipated therapy fees and payments you can expect before services are provided.

You may request a Good Faith Estimate at least one business day prior to your scheduled appointment by contacting our intake team at intake@walshbehavioral.com.

For additional information about your rights under the No Surprises Act, including details on out-of-network reimbursement and Good Faith Estimates, please visit www.cms.gov/nosurprises.