Depending on the method of payment, the referral process may vary with each client.
Use the form below to make a referral to our office:
[titled_box title=”Self-Pay Clients” variation=”teal”]Self-Pay clients with private insurance– please call your insurance company to determine your out of network reimbursement rate. You would be expected to pay for your sessions (via cash or credit card) prior to the delivery of services. Upon request, we can provide you with a “superbill” to submit to your insurance company for reimbursement. Therapy sessions can be provided via web based video therapy (depending on your therapist). [/titled_box]
$250 – initial evaluation and psychiatric evaluation
$75 – per med mgmnt follow up session
$125- per 45 min indiv therapy session
$60 – per 30 min indiv therapy session
$135 – per 45 min family therapy session
$40 – per 45 min group therapy session
[titled_box title=”Private Contracts” variation=”mossgreen”]All agencies and individuals interested in setting up a private contract should contact the clinic to speak with the CEO or Program Director in order to discuss contract specifics.
Phone: (410) 730-2385
Email : firstname.lastname@example.org [/titled_box]
[titled_box title=”MD Medicaid Clients” variation=”teal”]The following information is needed to process Medicaid clients:
- Medicaid card
- Custody orders (as applicable for minor children)
- If both parents have legal custody then both parents must give permission allowing the child to engage in therapeutic services
- All psychiatric/psychological/psychosocial evaluations completed over the last 1-3 years (where available) should be faxed to us by the first appointment.
- Court orders must be presented and release of info signed for court ordered treatment