THERAPEUTIC TIME INC.

Psychological Services

Description	Price
Clinical Interview/Intake Session (2 hour minimum)	$400
Individual Session	$200 per hour
Family or Couple Session	$250 per hour
Preparation and Review of Written Report (if needed)	$200 per hour
Telephone Consultations (as deemed appropriate)	$150 per hour

Cancellation & Rescheduling

Customary charges will be invoiced as cash fee sessions to the client for services that are canceled or need to be rescheduled within less than 24 business day hours. If the time allotted cannot be rescheduled because there has not been enough notice to contact clients and rescheduled treatment sessions, those hours will be invoiced at the customary fee of $400 (Clinical Interview/Intake Session) /$200 (Individual sessions)/$250 per hour (Family/Couple sessions).

Non Paid Balance

For all balances outstanding 30 days after the billing date, interest will be charged on the outstanding amount at the rate of 30% APR.

Psychological Assessment

Description	Price
Including Clinical Interview (minimum 2 hours= $600)	$300 per hour
Scoring and Test Administration	$200 per hour
Preparation and Review of written report	$200 per hour
Review of Records/Research	$250 per hour

Court Requirements & Appearances:

Description	Price
Review of Records/Research	$250 per hour
Travel Time (portal to portal & payable at time of attendance)	$150 per hour
Deposition (payable at time of deposition) (2 hour minimum)	$600 per hour

There will be a charge of $1200 for depositions cancelled with less than 24 business day hours’ notice if scheduled locally; 36 hours if scheduled out of area. (50 miles or Farther).

Description	Price
Court Appearance ( payable at time of court appearance) (minimum ½ day= 4 hours)	$800 per hour

There will be a charge of $1600 for court appearances canceled with less than 24 business day hours’ notice if scheduled locally; 36 hours if scheduled out of the area. (50 miles or Farther)

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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 do not 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 http://www.cms.gov/nosurprises or call 800-368-1019.

www.cms.gov/nosurprises for more information about your rights under federal law.