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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Rigby on December 4, 2003, at 23:51:56
Hi All,
Just wondering what others think about the rate that they're paying for therapy. Also, wondering if you think this type of discussion should be "off the clock."
My rate was $85. About a year into it, right around the time I was considering quitting, I said I couldn't pay that rate and basically my therapist let me pay what I thought I could pay: $60/session, once/week.
Tonight we discussed her increase in rates in general for 2004. For current clients paying $85 it goes to $90. For new clients it's $100.
I need to mull what I want to do. I feel greatful she allowed me a year at this really low rate and don't want to take advantage of her or of that *but* I still feel funny paying $85/session (not to mention $90) out of pocket (insurance doesn't cover it.)
I know there's no "answer" but I just was wondering how others process rate increases and how you come to a decision about how much or whether you can pay.
Thanks!
Rigby
Posted by Dinah on December 5, 2003, at 8:57:14
In reply to Rates, posted by Rigby on December 4, 2003, at 23:51:56
I would take very poorly indeed to a rate increase. But of course, I'm already paying well over the average in our area at $110 a session, and over one and a half times what he gets from people who are covered by insurance. And there's no discount for going twice a week. Moreover, since he moved, I have to pay an additional $500+ in parking per year. I'd probably do it because I have no choice, but I'd resent the living h*ll out of it.
But it's a personal decision. I guess it depends on the going rate in your area, how valuable you find her services, and of course, what you can afford to pay.
Posted by Poet on December 5, 2003, at 9:21:57
In reply to Rates, posted by Rigby on December 4, 2003, at 23:51:56
Hi Rigby,
My therapist has never mentioned rate increases, maybe it's because she knows I can't afford to pay more. Her normal charge is $100 per session, I pay $60.
My insurance doesn't cover my therapist because she's not a MD or PhD (she's a MSW.) I could afford to pay $5 or $10 more a session, but not the full rate.
Ask your therapist if it's okay to pay the $5 rate increase for current clients. Then you'd be paying $65 per session.
Poet
Posted by judy1 on December 5, 2003, at 10:52:03
In reply to Rates, posted by Rigby on December 4, 2003, at 23:51:56
where I live (so. cal), the rates are: $75/ for an MSW therp, $110 for a Ph.D. psychologist, and $200-$250 for an M.D. shrink who does therapy and meds. I guess it all depends on if you feel you are benefitting from your current therp, if you are it's hard to put a price on that. good luck with your decision- judy
Posted by noa on December 5, 2003, at 11:52:52
In reply to Re: Rates » Rigby, posted by judy1 on December 5, 2003, at 10:52:03
I think that rates also vary a lot depending on location, how experienced the therapist is, etc.
My therapist also allowed me to negotiate a lowered fee. He had been on my insurance plan, but went off of it. In any event, on the insurance, despite his usual fee of $130, the insurance would only allow him to collect a total of $85, from a combined co-pay from me of about $22 and the remainder from the insurance (minus my annual deductible of $300).
After he went off the insurance, he told me that he could be flexible for continuing patients who have that insurance, and said I could stay at the $85 rate, which I paid and then submitted forms for reimbursement from the insurance company. THere would be the deductible and then they pay certain percentages for the first 5 sessions, followed by a lower percentage for the next 10 sessions and then a lower percentage for any remaining sessions for the year.
WHen he told me he was raising his fees last year to $145, he asked me to think about whether I could make an increase in what I paid, but that he would be fine with me staying at the same amount ($85). Since I was about to have a salary increase, I told him that once I started the higher salary, I would increase to $100, and that was agreeable to him.
The truth is, when I was trying to figure out how much I could afford, I really didn't know exactly because I don't have a really good sense of my budget. I think I should figure that out and see if I'm paying him enough or is it time for me to increase what I pay. Maybe I should do so if I stay at my job and get an annual increase when contracts are renewed in July. But I'll need to get help figuring out my budget. That's hard for me.
Posted by Susan J on December 5, 2003, at 12:08:48
In reply to Rates, posted by Rigby on December 4, 2003, at 23:51:56
Wow,
My therapist only charges $65 a session. Since I'm in the DC area, which is expensive, I'm surprised mine is cheaper than all of yours. Hmmmm, don't know what to make of that.
And mine's covered by insurance. I pay $20 of the $65 each week.
And why the heck don't insurance companies cover therapists (MSWs) as well as psychiatrists/physicians? It's a heck of lot cheaper to pay for a therapist than a doc. My insurance actually makes you go to a therapist first to see if you even *need* a p-doc.
But then, my brother's insurance made him go to his primary care physician to get a referral to a psychiatrist to get a referral to a therapist. Not just written referrals- he has to see the docs, which means the insurance company will have to pay their share to three health care providers, not just one.
So stupid.....
Posted by Miss Honeychurch on December 5, 2003, at 12:15:54
In reply to Rates, posted by Rigby on December 4, 2003, at 23:51:56
Mine charges $100/hour (clinical psychologist, PHD). He gives the insurance company the rate of $75 an hour, of which I pay $35 each visit. Once my insurance runs out (I have been given 30 sessions), my therapist said he would charge me the discounted insurance rate of $75 instead of his standard.
Posted by noa on December 5, 2003, at 14:12:05
In reply to Re: Rates, posted by Miss Honeychurch on December 5, 2003, at 12:15:54
Susan,
I wonder if the $65 rate is the one dictated by the insurance company?
Posted by mair on December 5, 2003, at 14:15:23
In reply to Re: Rates, posted by Miss Honeychurch on December 5, 2003, at 12:15:54
My therapist charges me $105 per session which is a discounted rate since I go twice a week. I'm not sure what she is otherwise - maybe $110 or $115. For a very long time I paid $95. Unbeknownst to me, she has raised her rates several times since I started but she kept current patients at the same rate they started with. A recent rent increase made her decide that she had to raise current patients as well.
I pay the bills up front and submit claims to my insurance company. I have a very good plan in that there are no limits on the number of times I can see her, and I CAN see her even though she's not part of their network. (she dropped them a couple of years ago in total frustration). The company would cover more of the cost of each session if she were part of the network but it's not that big a difference. I think they pay $69 of the $105.
Recently I was faced with the scary prospect of being forced into a different policy where I would be considerably more limited, and probably would have been required to see someone in the network. She told me that she'd reduce the cost of my sessions substantially if that happened, but I don't think I'd feel at all comfortable with that. I think I'd just bail out of therapy instead. She is a PhD clinical psychologist. I think there are any number of MSWs in my insurer's network. I think they actually include very few PhDs for cost reasons.
Mair
Posted by Susan J on December 5, 2003, at 14:20:36
In reply to Re: Rates, posted by noa on December 5, 2003, at 14:12:05
> Susan,
>
> I wonder if the $65 rate is the one dictated by the insurance company?It's entirely possible. My medical plan contracts with a mental health managed care program and I could only pick from certain providers. But when I missed an appointment with my therapist without notice, she charged me the $65. So, she was either being nice, or that's her regular rate.
But, after seeing what you guys pay, I am very thankful for my measly $65 rate......
Susan
Posted by stjames on December 6, 2003, at 0:54:19
In reply to Rates, posted by Rigby on December 4, 2003, at 23:51:56
Hmmmm,
The best treatment I have gotten in 20 years
was out of pocket & cost the most, 120/hr for the PhD and 120/hr
for the psychopharmacologist. The MD was actually
quite cheap. 1 one hr initial session, 20 min med
checks twice a year. Everything else was for free,
by phone. Meds questions, changing meds was all done by phone. Shoot, I bill out at 120/hr to fix peoples networks.I find if I am honest about my finances, docs that I have a history with are very willing to cut their fees. Just tell your doc you can't afford the new rates and see what happens.
Posted by Rigby on December 8, 2003, at 17:25:04
In reply to Rates, posted by Rigby on December 4, 2003, at 23:51:56
Thanks *everyone* for their input. I'm still mulling.
Here's another question for you: I just did a calculation based upon net pay. If you make $40K per year and estimated you net $26K if you spend $85/week on therapy that's over 15% of your take-home pay on therapy.
This made me think: What percentage of your take-home are you willing to put into therapy?
Rigby
Posted by Dinah on December 8, 2003, at 19:05:55
In reply to Percentage of Take-Home $ Into Therapy, posted by Rigby on December 8, 2003, at 17:25:04
25%
It makes me woozy to think about it.
Posted by tabitha on December 9, 2003, at 1:12:40
In reply to Re: Percentage of Take-Home $ Into Therapy » Rigby, posted by Dinah on December 8, 2003, at 19:05:55
When I try to justify the expense I think it's comparable to tithing to your church. Or in the ballpark of what day-care costs for working moms.
How I look forward to the day when I don't need it anymore. When I write the weekly check, I think of what I'd have if I spent that much on new clothes, or furniture, or invested it. I'm a person who thinks hard about even spending $20 on buying something, so it's hard for me to accept spending hundreds per week on therapy (I'm doing multiple sessions).
This is the end of the thread.
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