Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost. At the Danielsen Institute, we do our best to get accurate information from your insurer and provide that information to you and your clinician so that you may discuss as necessary and set the self-pay fee that every client has in case they do not cancel an appointment more than 24 hours in advance or if their insurance declines to pay for any reason. The benefits quoted to us by your insurance company and the self-pay fee set by your and your therapist will be provided to you on a payment agreement form. Your self-pay fee will never be more than the maximum standard fee for the service here at the Danielsen Institute. Should your insurance policy include a deductible, any visit that your insurer claims is part of that deductible, and it is charged to you at the usual and customary fee for the service as determined by your insurer.
The Danielsen Institute Clinic standard fees and codes for the most common services we provide are listed here. If you wish to know what your insurance company’s usual and customary fees are, we recommend that you contact them directly.
| Initial “Intake” appointment (90791 or 90792) | $250.00 |
| Individual therapy, 17-53 minutes (90834, 90832) | $150.00 |
| Individual therapy, 53+ minutes (90837) | $200.00 |
| Couples/Family therapy (90847) | $175.00 |
| Group therapy (90853) | $45.00 |
| Medication Management, 40 minutes (99215) | $250.00 |
| Medication Management, 25 minutes (99214) | $175.00 |
If you need information about the charge for a service not listed here, please call our main desk at 617-353-3047.
For questions or more information about your right to a Good Faith Estimate, click here, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.