All Services, CPT Codes, & Fees
99422, 11-20 minutes Online digital evaluation and manage $31.00
90875, 20-30 min Psychophysiological therapy w biofeedback $85.00
99423, 21+ MIN Online digital evaluation and management $50.00
90836, 38-52 MIN PSYCHO WITH MED SERV $125.00
90834, 45 Min Psychotherapy $125.00
90837, 60 Min Psychotherapy $125.00
90837, 60 Min Teletherapy $125.00
90838, 60+ min Psych Eval with Med serv $125.00
99396, Annual physical/exam 40-64 $120.00
99394, Annual PX 12-15 $120.00
99395, Annual PX for 18-39 $120.00
97171, Athletic Training Evaluation, 45 mins, $150.00
97172, Athletic training, reevaluation, $65.00
90901, Biofeedback Session $125.00
123, Bounced Check Fee $12.50
96127, Brief emot/behav assmt, w/scor/ instru w/ med serv $30.00
00001, Business Consultation, $125.00
00002, Business Coaching, $300
00003, 2 Hour Intensive Trauma Resolution Session with Dean & Jessica, $ 1500
90792, Complete Psych Eval with Med Serv, $225.00
99215, Comprehensive medical follow up visit, $200.00
55555, Consultation $125.00
44444, Court Appearance $125.00
96110, Develop screening, per instrument, doc, and scoring $200.00
99404, EAP code $125.00
99213, Est Pat Office Visit- Intermediate $175.00
90847, Family therapy (patient present) $150.00
90846, Family therapy (without client present) $150.00
90853, Group Therapy $55.00
99202, Initial Medical Evaluation, $275.00
99205, Initial outpt encounter level 5, $225.00
90785, Interactive complexity (add on) $30.00
LENS70, LENS Follow Up Session $70.00
LENS12, LENS Session $125.00
222222, MEDICAL RECORDS REQUEST $25.00
00000, no show/late cancel $65.00
111111, No Show/Late Cancel Group $25.00
99214, Office Visit-- Moderate complexity $200.00
99421, Online digital evaluation and management service, $15.00
90837, OPTUM ONLY EAP $125.00
99417, Prolong office E&M serv -up 15min over 74min $50.00
90791, Psychiatric Diagnostic Interview, $150.00
90833, Psychotherapy 16-37 min with med serv, $75.00
90840, Psychotherapy for crisis (each adtl 30 mins) $100.00
90839, Psychotherapy for crisis first 60 mins, $225.00
90832, psychotherapy services rendered for 30 minutes $75.00
99457, Remote Patient Monitoring $85.00
90889, Report Writing for Client, per hour $125.00
SP100, Self Pay $100 $100.00
SP125, Self Pay $125 $125.00
SP150, Self Pay $150 $150.00
SP50, Self Pay $50 $50.00
SP65, Self Pay $65 $65.00
SP85, Self Pay $85 $85.00
99453, Setting up the client on remote patient monitoring $60.00
92508, SLP Group Session $55.00
92507, SLP Indiv Session $125.00
99080, Special Report info greater than stand med commun $25.00
90836, TELE 38-52 MIN PSYCHO WITH MED SERV $125.00
99215, Tele- Est Pat High Complexity $225.00
96127, TELEMED brief emo/bev assmt, w/ score, per inst $200.00
90792, Telemed Comp Psych Eval with med serv $225.00
99205, Telemed Initial oupt encoun level 5, $75.00
99354, Telemed Prolonged encounter up to 1 hr, $85.00
90833, Telemed Psychotherapy 16-37 min with med serv $75.00
96127 Telemed-Brief emot/behav assmt, w/ scoring /instr $30.00
99213, Telemedicine - Est Patient- Intermediate $175.00
99214, Telemedicine - Est Patient- Moderate $200.00
99417, Tele-Prolong office E&M serv -up 15min over 74min $50.00
