Fees/Forms

 

Our Established Fees

 Brief Group Assessment
$140-160
Initial 2 Hour Assessment
$210-240
50 Minute Individual Therapy Session
$140-160
90 Minute Family Meeting
$210-240
30 Minute In Person Parent Check-In
$70-80
60 Minutes Weekly Group Session
$50-$60
90 Minute Weekly Group Session
$60-$75
Intensive Outpatient Program
Call for Details

Referral Form +

Client Portal

Click to download

Please complete and fax referral form to:
1 (833) 230-5606 

Current Clients:

Click this link for access to your Simple Practice Client Portal

Session rates vary according to clinicians’ license and experience level. Please call for details.

Queen City Counseling is not currently affiliated with any insurance panels and requires payment at the time of service.

Benefits of Self-Pay

When an individual self-pays for therapy as opposed to utilizing insurance, both confidentiality and treatment decisions remain solely between you and your therapist. Insurance plans require a diagnosis and additional clinical details to reimburse services and reserve the right to audit your records. Some plans may limit the number or frequency of sessions that are covered rather than allowing these decisions to remain between you and the treating clinician. Furthermore, your entire therapeutic experience including diagnosis is made available to future insurance companies. When utilizing health insurance to pay for therapy you are relinquishing confidentiality, treatment decisions, length of therapy and other pertinent decisions to your insurance company.

Reimbursement Options

If you wish to use health insurance, you may be able to use your out-of-network insurance benefits to offset the cost of services. If you wish, we will provide weekly invoices and or/a monthly Superbill in exchange for your payment which you can then submit to your insurance company to request reimbursement for some or all of the session fee. Some insurance companies allow clients to apply psychotherapy fees to their yearly out-of-pocket deductible. To determine if you have out-of-network benefits, check your company’s website or call the telephone number on the back of your insurance card.

Also, some employers allow the use of flexible spending accounts, medical savings accounts, or health reimbursement arrangements. To determine if you may utilize a flexible spending account, medical savings account, or health reimbursement arrangement to pay for therapy, call your employer’s human resources or benefits department.

How To Find Out More About Your Options

To determine if you have out-of-network benefits, check your company’s website or call the telephone number on the back of your insurance card. The customer service representative will be able to answer your questions. Be sure to ask what documentation they require in order to reimburse you.

To determine if you may utilize a flexible spending account, medical savings account, or health reimbursement arrangement to pay for therapy, call your employer’s human resources or benefits department. Be sure to ask what procedures you must follow and what documentation they require in order to reimburse you.

No Surprises Act

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 1 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 or call 1-800-985-3059.

(704) 457-8222

5950 Fairview Rd, Suite 150 Charlotte, NC 28210