Rates & Insurance

Initial Consultation

I offer a complimentary 15 minute telephone initial consultation.  Because goodness of fit between a client and therapist is a vital part of the therapeutic relationship I recommend talking with more than one therapist, if possible, to ensure the best match for you. 

 

Appointments

Fee for service appointments for individual or couples  are either fifty or ninety minutes in length.  Group therapy is 75 minutes.  

  • Individual Psychotherapy (50 minutes):   $140.00

  • Individual Psychotherapy (90 minutes):   $175.00

  • Group Therapy (75 minutes): $85.00  

                   

Payment may be made by either cash or check. Typically, I recommend meeting once a week, although more or less frequency may be determined more appropriate at any stage during the therapy process. 

 

As the time scheduled for your appointment is reserved for you, I ask that 48-hours notice is given if it is necessary to cancel an appointment.  If notice is given in less than 48-hours a charge for the cancellation is incurred, which is the fee-for service cost of the scheduled session, $140.00 or $175.00.

 

Web-Based Psychotherapy (Telehealth) Available for Virginia and Maryland Residents

Web-based Psychotherapy is available via www.doxy.me. HIPPA compliant. Confidential and secure.  

Telehealth for Florida Residents

https://www.flhealthsource.gov/telehealth/

 

Insurance

Presently, I am an in-network provider for the following insurance companies:

  • Anthem BCBS PPO

  • Care First BCBS:  PPO, Federal Employee Program

  • *Non-Network Provider for Tri-Care

 

I am no longer a Provider with Carefirst BCBS Blue Choice (HMO/Commercial) and Carefirst BCBS Blue Card (Out of Area plans).

I am not a Medicare provider.

 

Beginning April 2018, I will no longer be accepting Cigna insurance.  

Therapy, Insurance & 
Thoughts to Consider

Because I am licensed as a clinical social worker my professional services qualify for reimbursement under most insurance plans.  I encourage you to become familiar with your coverage prior to beginning the therapy process, as well as aware of any changes that your carrier may make to your plan.  If I am not a network provider for your carrier, and you choose to file for reimbursement with your insurance company, I will provide you with a receipt for services rendered so that you may file a claim.

If I am a provider (in-network) I will file for reimbursement through your carrier. 

Please consider the following if you chose to utilize your insurance benefits. 

 

  • Confidentiality: All insurance companies require some information about the reason for psychotherapy services in order to process a claim. In addition, managed care plans often require detailed information regarding the problem for which you are seeking help.

 

  • Control of Treatment: Managed care companies may use the information to decide if treatment is medically necessary, what kind of therapy is approved, and, later, if it should continue. Many of the insurance company case managers who make these decisions have limited training in psychotherapy and treatment planning. 

 

  • Psychiatric Diagnosis: Health insurance is designed to pay for the treatment of illness. Therefore, a psychiatric diagnosis code must be given before most insurance companies will pay for services rendered.

              Good Faith Estimate

 

Effective January 1, 2022, a ruling went into effect called the "No Surprises Act" which requires clinicians to provider a "Good Faith Estimate" to individuals who are uninsured or utilize self-pay. The Good Faith Estimate (referred to throughout this document as “GFE”) works to show the cost of items and services that are reasonably expected for your health care needs for an item or service, a diagnosis, and a reason for mental health services. The estimate is based on information known at the time the estimate was created. The GFE does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur and will be provided a new GFE should this occur. If this happens, federal law allows you to dispute (appeal) the bill if you and your provider have not previously talked about the change and you have not been given an updated GFE. 

Under Section 2799B-6 of the Public Health Service Act (PHSA), health care providers and health care facilities are required to inform 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 of their ability, upon request, or at the time of scheduling health care items and services to receive a GFE of expected charges. 

Note: The PHSA and GFE do not currently apply to any individuals who are using insurance benefits, including "out of network benefits” (i.e.., submitting superbills to insurance for reimbursement). 

Timeline requirements: Providers are required to provide a GFE of expected charges for a scheduled or requested service, including items or services that are reasonably expected to be provided in conjunction with such scheduled or requested item or service. That estimate must be provided within specified timeframes: 

  • If the service is scheduled at least 3 business days before the appointment date: no later than 1 business day after the date of scheduling;

  • If the service is scheduled at least 10 business days before the appointment date: no later than 3 business days after the date of scheduling; or 

  • If the uninsured or self-pay individual requests a GFE (without scheduling the service), no later than 3 business days after the date of the request. A new GFE must be provided, within the specified timeframes if the individual reschedules the requested item or service. 

Common Services from Lenée N. Essig, LCSW, SEP, LLC:

  • 90791: Initial Psychotherapy intake 

  • 90834: Ongoing therapy appointments (approx. 38-45 minutes)

  • 90837: Ongoing therapy appointments (approx.. 53-60 minutes) 

  • 90847: Family/Couples appointments (approx.. 45-60 minutes) 

  • 90853: Group Psychotherapy (approx. 60 minutes)

  • 90833: Psychotherapy Add-On to Psychiatric Appointments (included in a 30 minute appointment)

Common Diagnosis Codes used by Lenée N. Essig, LCSW, SEP, LLC:

Below are common diagnosis codes.  However, the list is not exhaustive. With that said, diagnosis codes can change based on many factors. Please speak to your provider with any questions or concerns. 

  • Adjustment Disorder (F43.23) 

  • ADHD (F90.09)

  • Mental Disorder, Not Otherwise Specified (F99)

  • Depression (F32.9)

  • Anxiety (F41.1)

  • Bipolar Disorder (F31.9)

  • Post-traumatic Stress Disorder (F43.10)

Every individual’s mental health treatment journey is unique and personalized. How long you need to engage in mental health services and how often you attend sessions will be influenced by many factors, including, but not limited to: 

  • Your schedule and life circumstances

  • Your provider’s availability 

  • Ongoing life challenges

  • The nature of your specific challenges and how you address them

  • Personal finances

You and Lenée N. Essig, LCSW, SEP, LLC will continually assess the appropriate frequency of services and will work together to determine when you have met your goals and are ready for discharge and/or a new "Good Faith Estimate" will be issued should your frequency or needs change.