Clarity Counseling Seattle

Financial Info

Rates, Payment, and Insurance Questions

Standard Rates

We understand that therapy is an investment, of both your time and your money. An investment into yourself and perhaps also into your relationship, and the therapists in our practice do everything we can to help you to maximize your investment. Rates for the standard 50-minute appointment are $160 for Hanna Kokko and Sheila Poquiz; $175 for Bill Aloe, Mary-lynn Ballew, Lisa Stewart, Corey Thompson, and Sara Whitney; $195 for Justin Pere. We do not charge more for the initial intake session, nor do we charge more for couples or family therapy than we do for individual therapy.

 

Health Savings Accounts and Flexible Spending Accounts

We are happy to run your sessions through your health savings account (HSA) or flexible spending account (FSA), which can be used to pay for medical expenses such as therapy (both individual and couples therapy) and can often significantly decrease the cost of treatment.

 

Health Insurance

For individual clients, we provide invoices for reimbursement of whatever your out-of-network benefits will cover. Many of our individual clients choose to submit to insurance for out-of-network coverage, and what we most often see is 20-60% reimbursement (for example, Premera most often reimburses $94 per session). We encourage you to contact your health insurer to inquire about your out-of-network coverage, as each policy varies.

For couples/relationship clients, while we would love for you to be able to utilize your insurance benefits, the reality is that health insurance rarely covers relationship therapy, regardless of how great your plan is or even what your insurance company may have told you. We know that this is often surprising and unwelcomed news so we ask that you please take a few minutes to read the explanation below so that you can make informed decisions about your care.

Do you take our insurance for couples/relationship therapy? is a common question that takes a moment to answer (believe it or not this is the short version!)...

If your insurance company tells you that they do indeed cover couples counseling, they are referring to the following scenario: one person's mental illness is being treated and the partner is only present to support that person's mental health treatment. When health insurance is utilized for therapy, the insurance company will only cover mental illnesses, such as Major Depressive Disorder or Generalized Anxiety Disorder or ADHD. By definition, illnesses afflict one person at a time. Insurance is known to be somewhat flexible about how a mental illness is treated, meaning that if a spouse needs to be involved and present in the treatment of the mental illness, insurance will allow for that.

Please note that in this scenario, one member of the couple is officially diagnosed with a mental illness (considered the "identified patient" by the insurance company), and the treatment file and treatment progress notes that the therapist has to write and keep reflects ongoing treatment for that patient's mental illness. So again, in this scenario, couples therapy is only covered by health insurance because the treatment is focused solely on one partner's diagnosed mental illness, and the other partner is only present to be part of their spouse's treatment of their mental illness. Please also note that in this scenario, a valid mental illness needs to be assigned by the therapist and sent to the insurance company, where that diagnosis becomes part of the patient's permanent medical record.

If the person who will serve as the “identified patient” is already in individual counseling for that mental health diagnosis, the couples therapist cannot bill insurance, because the person is already receiving individual treatment for that diagnosis. Health insurers are assuming that couples therapy is always focused on the treatment of one spouse's mental illness.

The challenge is this: most couples do not enter couples therapy to work on one person's mental illness. They instead seek relationship counseling for help with communication, conflict, emotional connection, parenting, trust, sex/intimacy, and all sorts of other important reasons to seek help from a relationship counselor. But these focuses of therapy are not "medically necessary" mental illnesses, and thus the scenario described above does not apply, given that health insurance only pays for treatment of diagnosable mental illness. Additionally, the couple as a unit is the focus of therapy, and so billing insurance as if the couple's sessions are treating just one individual is potentially insurance fraud.

This is a frustrating reality for both the public and for therapists. We would love for couples to be able to utilize their insurance benefits for relationship help, but we are forced to adhere to the very strict rules around what is covered and what isn't. And we need to be careful because breaking these rules really can be insurance fraud.

*Please note: Very rarely, we do see some insurance carriers cover couples therapy. The way to clarify this with your insurance is to ask if your plan covers what is called a “Z Code” diagnosis, specifically the code Z63.0. As mentioned above, all insurance billing must include a mental health diagnosis (they want to know what they are paying for), and there is a group of relationship-related codes that start with Z (such as the Z63.0 example above, which is for “Relationship Distress with Spouse or Intimate Partner”), that most insurance plans exclude. Again, most insurance plans do not cover Z codes so it is unlikely that your insurance will allow for this to be the diagnosed reason for couples therapy, however it may be worth checking with your specific plan. The exact question to ask your insurer is this: "Does my policy cover diagnosis code Z63.0 for procedure code 90847 in an outpatient office setting?"

If a "Z code" is indeed covered by your specific insurance policy, we are happy to give you an invoice to submit to your insurer for whatever out-of-network benefits you have, so that you may receive some reimbursement.

We know that relationship therapy is not inexpensive - that it's an investment. And we do everything we can to help you to get the most out of your investment. Therapy sessions with us range from $160 - $195 for the standard 50-minute appointment, which is about average for this area and for the advanced training our therapists have.

So thank you for your patience in reading through all of that, and we know that understanding health insurance can be quite confusing so please always feel free to follow up with any questions you have.

Frequently Asked Questions

We completely understand this request. The reason why we're careful not to start someone with one of our therapists without first establishing a weekly or biweekly time slot that works for both you and the therapist is that there are very few openings in our schedules. So if we don't reserve one of those few available time slots for you right now then most likely the weekly or biweekly spot that's available now will be claimed by someone else by the time you've first met with the therapist.

Most times, the people who start with our therapists decide to work with them on an ongoing basis, so we want to avoid a scenario where you get started with a therapist, decide to work with them, but then find that they have no available time slot in their schedule that works with your own. In the past, we've had moments at the end of a first session that go something like this:

Client: "You're great, I can't wait to work with you! Let's get it in the books!"

Therapist: "Wonderful, well I'm excited to work with you too! So the spots I currently have available are every other Tuesday at 2pm and every Thursday at 9am...which would you like?" 

Client"Oh shoot, neither of those work for me."

So we need to first make sure that your availability and the availability of the therapist align, which means deciding on which weekly or biweekly time slot you'll be claiming.

It's worth noting that you're not signing a contract with us, so you can end therapy at any time. We just need to first make sure you have a weekly or biweekly day & time reserved for you before moving forward, which is why our intake coordinator will discuss with you during an initial intake call which time slot you'd like to sign up for, should you wish to continue working with your therapist on an ongoing basis after your initial session.

Given that telehealth is a great option, absolutely! So many of the people we've helped since Covid hit have been in locations that are often hours away from our Seattle office, allowing a great number of clients to receive needed services. Our therapy license does not extend outside of Washington State but it does allow us to help anyone within the state if they are open to using the telehealth approach, which has worked wonderfully for hundreds of couples and individuals over the past few years.

Typically people attend therapy for a number of months. How long you stay in therapy is completely up to you, as you're not signing a contract with us, but usually people find that they need to be in therapy longer than they initially thought they would have. And it's rare that people get what they need from therapy from just a few sessions, so if you do start with us then we encourage you to do so with the understanding that therapy is a process that takes a while.

The therapists in this practice work very hard in sessions to get you in and out of a course of therapy as soon as possible, but for most people it usually takes a while. People and relationships are complex!

What we know about therapy is that it simply can't meet your goals if therapy sessions don't occur at least every 2 weeks, so nearly all therapists everywhere will require that sessions have a frequency of either weekly or every other week to start.

You're very welcome to scale back your frequency later on but we always need to start treatment on a weekly or biweekly basis. People we work with have access to our online calendars, so at some point in therapy some folx decide to give up their weekly or biweekly time slot and instead start using our online calendar to book appointments at a frequency of their choosing.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes  related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your health care provider, and any other provider you choose     for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises

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