Common use of Ending Therapy Clause in Contracts

Ending Therapy. Ending therapy may occur at any time and be indicated by either the client or the therapist. If you are unhappy with therapy, please share your concerns and perhaps changes can be made to make therapy more helpful to you. Generally, therapy ends when you have accomplished the goals you established at the beginning of therapy. If you stop attending sessions, I generally do not call out of respect for your choice. Do not interpret not receiving a call as me not caring about you. If you decide at a later date that you are ready to become involved in therapy again, please feel free to call and ask to resume therapy. I understand that sometimes it is just not the right time to devote the energy necessary for successful therapy. Rates: Service Rate Initial Interview (Intake) $ 150 Subsequent Interviews or Therapy Sessions, per 45-50 minute session $ 135 Additional time, per 15 minute increments $ 35 Sessions, per 30 minutes $ 80 Wellness Sessions, per 45-50 minutes $ 135 Collaborative Divorce Services, per hour $ 200 Telephone Consultation, per 15 minutes or any portion thereof $ 35 Any other service performed on behalf of client such as letter writing, completion of forms, 15 minute increments $ 35 No show fee Full rate of scheduled appointment Court preparation/testimony $ 2000 or $300 per hour, whichever is greater Co-payments and Deductibles: All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co- payments and deductibles from clients can be considered fraud. Please help me in upholding the law by paying your co-payment or paying toward your deductible each visit. Knowing your insurance benefits is your responsibility. Please verify your benefits before coming to the first appointment. Generally, you will find a 1-800 number on the back of your insurance card to obtain your benefit information. Billing codes for my services include: 90791, 90837, 90834, and 90847. Please ask your insurance representative if these codes are covered by your plan and whether you will be paying a copay or towards a deductible.

Ending Therapy. Ending therapy may occur at any time and be indicated by either the client or the therapist. If you are unhappy with therapy, please share your concerns and perhaps changes can be made to make therapy more helpful to you. Generally, therapy ends when you have accomplished the goals you established at the beginning of therapy. If you stop attending sessions, I generally do not call out of respect for your choice. Do not interpret not receiving a call as me not caring about you. If you decide at a later date that you are ready to become involved in therapy again, please feel free to call and ask to resume therapy. I understand that sometimes it is just not the right time to devote the energy necessary for successful therapy. Rates: Service Rate Initial Interview (Intake) $ 150 Subsequent Interviews or Therapy Sessions, per 45-50 minute full session $ 135 Half/ Part Hour Sessions, per 30 minutes $ 80 Additional time, per 15 minute increments $ 35 Sessions, Psychological Evaluations $ 140 per 30 minutes $ 80 hour billed to insurance; out-of-pocket pricing varies based on assessment- please call Wellness Sessions, per 45-50 minutes $ 135 Collaborative Divorce Services, per hour $ 200 Telephone Consultation, per 15 minutes or any portion thereof $ 35 Any other service performed on behalf of client such as letter writing, completion of forms, 15 minute increments $ 35 No show fee Full rate of scheduled appointment Court preparation/testimony $ 2000 or $300 per hour, whichever is greater Co-payments and Deductibles: All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co- payments and deductibles from clients can be considered fraud. Please help me in upholding the law by paying your co-payment or paying toward your deductible each visit. Knowing your insurance benefits is your responsibility. Please verify your benefits before coming to the first appointment. Generally, you will find a 1-800 number on the back of your insurance card to obtain your benefit information. Billing codes for my services include: 90791, 90837, 90834, and 90847. Please ask your insurance representative if these codes are covered by your plan and whether you will be paying a copay or towards a deductible.

Ending Therapy. Ending therapy may occur at any time and be indicated by either the client or the therapist. If you are unhappy with therapy, please share your concerns and perhaps changes can be made to make therapy more helpful to you. Generally, therapy ends when you have accomplished the goals you established at the beginning of therapy. If you stop attending sessions, I generally do not call out of respect for your choice. Do not interpret not receiving a call as me not caring about you. If you decide at a later date that you are ready to become involved in therapy again, please feel free to call and ask to resume therapy. I understand that sometimes it is just not the right time to devote the energy necessary for successful therapy. Rates: *Payment is due prior at the beginning of the session Service Rate Initial Interview (Intake) $ 150 Subsequent Interviews or Therapy Sessions, per 45-50 45 minute session $ 135 Consultation, 60 minutes $150 Additional time, per 15 minute increments $ 35 40 Sessions, per 30 minutes $ 80 Wellness Sessions, per 45-50 45 minutes $ 135 Collaborative Divorce Services, per hour $ 200 Telephone Consultation, per 15 minutes or any portion thereof $ 35 40 Any other service performed on behalf of client such as letter writing, phone consultation, completion of forms, 15 minute increments $ 35 40 No show fee Full rate of scheduled appointment Court preparation/testimony $ 2000 or $300 per hour, whichever is greater Affadavit fee $500 Clinical Supervision, per hour $100 Please complete this section if you plan to file for payment through Blue Cross Blue Shield Insurance: Co-payments and Deductibles: All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co- co-payments and deductibles from clients can be considered fraud. Please help me in upholding the law by paying your co-payment or paying toward your deductible each visit. Knowing your insurance benefits is your responsibility. Please verify your benefits before coming to the first appointment. Generally, you will find a 1-800 number on the back of your insurance card to obtain your benefit information. Billing codes Client’s Name: Insurance ID: Insured’s Name: Insured’s DOB: Relationship to client: Co-pay: Deductible amount: Has your deductible been met for my services includethis year: 90791, 90837, 90834, and 90847. Please ask your insurance representative if these codes are Number of Sessions covered by your plan and whether you will be paying a copay or towards a deductible.per year:

Ending Therapy. Ending therapy may occur at any time and be indicated by either the client or the therapist. If you are unhappy with therapy, please share your concerns and perhaps changes can be made to make therapy more helpful to you. Generally, therapy ends when you have accomplished the goals you established at the beginning of therapy. If you stop attending sessions, I generally do not call out of respect for your choice. Do not interpret not receiving a call as me not caring about you. If you decide at a later date that you are ready to become involved in therapy again, please feel free to call and ask to resume therapy. I understand that sometimes it is just not the right time to devote the energy necessary for successful therapy. Rates: *All payments are due at the beginning of the session* Service Rate Initial Interview (Intake) $ 150 Subsequent Interviews Interviews, Therapy, Wellness, or Therapy Co-parenting Sessions, per 45-50 minute session $ 135 150 Additional time, per 15 minute increments $ 35 Sessions, per 30 minutes $ 80 Wellness Sessions, per 45-50 minutes $ 135 Collaborative Divorce Services, per hour $ 200 Telephone Consultation, per 15 minutes or any portion thereof $ 35 50 Any other service performed on behalf of client such as letter writing, completion of forms, 15 minute increments $ 35 50 No show fee Full rate of scheduled appointment Court preparation/testimony $ 2000 or $300 per hour, whichever is greater Affidavit Fee $500 or $300 per hour, whichever is greater Clinical Supervision $100 per hour Complete this portion if you plan to file for payment through Blue Cross Blue Shield. Insurance does not cover co-parenting sessions. Insurance only covers mental health services that are medically necessary. Co-payments and Deductibles: All co-payments and deductibles must be paid on the day of your appointment at the time beginning of servicethe session. This arrangement is part of your contract with your insurance company. Failure on our part to collect co- co-payments and deductibles from clients can be considered fraud. Please help me in upholding the law by paying your co-payment or paying toward your deductible each visit. Knowing your insurance benefits is your responsibility. Please verify your benefits before coming to the first appointment. Generally, you will find a 1-800 number on the back of your insurance card to obtain your benefit information. Billing codes for my services include: 90791, 90837, 90834, and 90847. Please ask your insurance representative if these codes are outpatient counseling is covered by your plan and whether you will be paying a copay co-pay or paying towards a deductible.. Insurance Information: Client’s Name: Insurance ID #: Insured’s Name: Insured’s DOB: Relationship to client: (parent, grandparent, guardian) Copay (if applicable): Deductible amount (if applicable): Number of therapy sessions covered per year: