At this time, I am accepting Anthem Blue Cross insurance and otherwise, accept payments directly based on the fee schedule. I request a full fee from those who are able, so that I can make accommodation for those who are in need. I can generate a super-bill to submit to other insurers for reimbursement.
Ketamine treatment is not covered by insurance, though aspects of the evaluation, management and psychotherapy may be covered or available for reimbursement.
Ketamine Assisted Therapy:
Follow-up: 30 minutes: $175
Follow-up: 45 minutes: $250
Individual Dosing sessions: $500 for 90 minutes
Preparation/integration: $250 for 45 minutes
Group based program.
The structure and costs are being defined
Reimbursable services typically fall into the following categories, with allowable amounts defined by each insurer (within PPO plans, not HMO plans – typically) and are covered at specified percentage (ie. 50-90%). After the initial evaluation, services are typically billed as a combination of a medication Evaluation and Management (E&M) and a psychotherapy session. A super-bill listing the codes and dates of service can be provided for your direct submission and reimbursement with your insurer.
For example: A 30 minute foll0w-up appointment with a higher complexity medication evaluation and management code (99214 – ie. $125 allowed reimbursement) combined with 20 minutes of psychotherapy (90833 – ie. $75 allowed reimbursement) would create an allowed amount of $200, that would then be adjusted to the out of network rate (ie. 60%) for a a total reimbursement of $120.