Private Pay Services Price List

Note these fees may change at any time and may be different for you depending on your individual circumstances.

We can accept payments by cash, money order, personal check or credit card (Visa, MasterCard, Discover, American Express). We also routinely accept referrals from churches and other non-profit groups that may be able to help you get the help you need. If you have any questions about our financial policies please call our Ogden office at (801) 475-0402 or our Tremonton office at (435) 257-6999 .

Service ID Number	Service Type	Description	Regular Fee	Private Pay Fee
	APPOINTMENT TYPES
90801	Initial Assessment and Documentation	First Session with counselor; 45-50 minutes	$185.00	$85.00
90806	Individual Psychotherapy	45-50 minutes	$135.00	$70.00
90853	Group Psychotherapy	45-50 minutes	$50.00	$25.00
	Group Psychotherapy	60-120 minutes	$90.00	$40.00
	Required Materials for All Groups	Materials for Class	inquire*	inquire
90847	Family Psychotherapy	45-50 minutes	$135.00	$70.00
90804	Individual Psychotherapy	25-30 minutes	$75.00	$45.00
	Missed Appointment	No Show or Cancellation without 24 hour notice	Self-pay fee	Self-pay fee
	Interactive Therapy...Add	Interpreter, Play Therapy, etc.		$20.00

	PSYCHOLOGICAL TESTING
90801	Initial Assessment and Documentation	First session with Psychologist; 45-50 minutes	$185.00	$90.00
96100	Psychological Testing and Assessments	Testing, Interpretation, and Report; per hour	$135.00	$90.00

	PHARMACOLOGICAL MANAGEMENT
90801	Initial Assessment and Documentation	First session with APRN; 45-50 minutes	$185.00	$100.00
90862	Pharmacological Management, brief	Medication Follow Up--APRN; 15 minutes or less	$75.00	$45.00

	CRISIS VISITS -- PHONE CALLS
99371	Phone Call Therapist-Pt/Other	Simple/Brief; 0-20 minutes	$45.00*	$45.00
99372	Phone Call Therapist-Pt/Other	Intermediate; 20-30 minutes	$60.00*	$60.00
99373	Phone Call Therapist-Pt/Other	Complex; 35-45 minutes	$110.00*	$110.00

	CRISIS VISITS - AFTER HOURS VISITS
99050	After Hours Services, per hour	Services provided outside of regular office hours	$185.00	$130.00
99056	After Hours Services, per hour	Services provided outside of office; ex: home	$185.00	$130.00
99058	Emergency Services, per hour	Services provided in office during regular hours	$185.00	$130.00
99510	Home visit for individual, family counseling	45-50 minutes	$185.00	$130.00

	DRUG AND ALCOHOL TREATMENT
90801	Initial Assessment and Documentation	First Session with Counselor; 45-50 minutes	$185.00	$85.00
90806	Individual Psychotherapy	45-50 minutes	$135.00	$70.00
90853	Group Psychotherapy	45-50 minutes	$50.00	$25.00
	Urinary Analysis	Panel Dip Urine Testing	$25.00*	$25.00
	SASSI or ASI	Testing Instruments	$25.00*	$25.00

	SPECIAL GROUP RATES
	Becoming a Love and Logic Parent	Single -- entire class	$95.00*	$95.00
	Becoming a Love and Logic Parent	Couple -- entire class	$150.00*	$150.00
	Required Materials for All Groups	Materials for Class	inquire*	inquire

	MISCELLANEOUS
	Official Letter or Report	Any letter or report sent to an outside agency	$65.00*	$65.00
	Testimony Fee	Court Testimony for child custody, etc. 1/2 day	$540.00*	$540.00
	Guided Imagery Sessions after Intake	Guided Imagery, NLP, or Hypnotherapy	$90.00*	$90.00
	Copies of Records	Records for all reasons not related to payment	$1.00 p/p*	$1.00 p/p

* These charges may not be billable to your insurance company.

We have contractual agreements with various insurance plans regarding the allowed amount for each service. These fees, co-pays, and deductibles can be discussed with your financial counselor at the time of service. Generally, those items above listed as "not billable"(*) are not billed to insurance companies but must be paid by the responsible party. If the insurance company does not pay, we will look to the responsible party for payment on the account. Co-pays or the full self-pay fee must be paid at time of service.

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