Copy of FAMILY FEE STRUCTURE

Family Fee Structure

Staff at Beyond the Individual, LLC provide a wide array of services including psychological therapy and assessment, applied behavior analysis (ABA) therapies, consultation, and training. Staff work with families to use industry standard codes to increase the likelihood of reimbursement which results in different fee structures depending on the service provided. Overall, individual services average $50-175/hour and group services $75-100/hour.

Billing and Service Model

After years of providing both psychological and behavior analytic services as an in-network provider and administrator overseeing these services, Dr. Ostmeyer originally decided to adopt a fee-for-service model at Beyond the Individual, LLC. She found that working within the constraints of these networks was not only stressful, but prevented her from providing the services in what she believed to be the most effective and productive manner. At the same time, she recognizes the need for reimbursement for more intensive cases. For this reason, two reimbursement structures are offered at Beyond the Individual, LLC.

Fee for Service Model:

Beyond the Individual, LLC maintains a fee-for-service model for all psychological services including individual therapy, family therapy, and diagnostic assessment services. On the surface, working with a fee-for-service provider may seem less cost-effective, but there are several benefits to such an arrangement including:

Ability to develop an individualized treatment and behavior plan without the delays and possible denials of working with a third-party contractor
The ability to work with a therapist who works to provide services using an evidence-based model rather than trying to make therapy fit the constraints of a third-party funder which may or may not be in line with current best practices or meet the needs of the client
More time spent on treatment plans and client goals rather than case conferences with insurance companies and paperwork

Clients may choose to use their out-of-network benefits with their insurance company and will receive statements with the information required to do so. Dr. Ostmeyer will provide additional documentation upon request, but will not work with any third-party-funder directly for these services..

If you are a Medicaid beneficiary, you acknowledge that your forgo your ability to utilize your Medicaid benefits if you choose to work with Dr. Ostmeyer for psychological services.

Insurance Reimbursement:

Beyond the Individual, LLC works with several insurance providers to provide applied behavior analysis (ABA) services. We will work with your insurance company to obtain authorization, bill services, and determine your patient responsibility. We are in the process of contracting with several insurance companies and currently are contracted with:

-Kansas Medicaid via UHC, Sunflower, and Aetna

-UHC commercial

-BCBS and New Directions

-Cigna

Psychological Therapy Services

Initial Diagnostic Interview: $300: This initial session lasts 60-90 minutes and is focused on the gathering of background information, setting treatment goals, and development of a plan for the intensity and frequency of intervention given goals and presentation.

Individual psychotherapy services: Cost varies based on time spent: These services involve meeting with the client and supports to work towards agreed upon treatment goals. If sessions last beyond 80 minutes, more than one code may be billed to cover services.

16-37 minutes: $87.50

38-52 minutes: $175

53-80 minutes: $262.50

Family therapy: $175 per 38-52 minute session: Family therapy sessions may be conducted with or without the client present. These sessions focus on teaching parents and other family members techniques to manage behavior, better understand their child and how to best support them, and help families work on relationships for a more positive and adaptive family life.

Consultation and training: $175/hour: This service covers time spent working with non-familial natural supports such as school teams, agencies, and support providers to support goals in the natural environment, increase consistency between settings, and provide psychoeducation regarding the child, diagnoses, and child development.

Phone consultations: $175/hour billed in 15 minutes increments: Phone calls lasting less than 15 minutes for the purposes of planning and scheduling are not billed to the family.

Preparation of Treatment Documents: $175/hour billed in 15 minute increments: Many of the treatments provided by staff at Beyond the Individual, LLC require extensive plan writing and data analysis to guide and update plans. For this reason, staff do charge for the preparation of documents and plans that are integral to the successful implementation of treatment by natural supports.

Travel: hourly rate billed in 15 minute increments: With a majority of intervention provided in the natural environment, staff at Beyond the Individual, LLC are required to travel to see clients. When possible, staff will meet in an agreed upon private location, such as a private meeting room at a local library, or via telehealth to limit the costs of travel as indicated. The client may also be requested to cover the cost of lodging if an overnight stay is required for sessions or training with distance-based clients or teams.

Clients will be asked to cover any additional fees (admission fees related to community-based goals for both the client and therapist, treatment stimuli, etc.) will be the client’s responsibility and are not billed as part of services. Anticipated additional charges will be discussed in advance during planning sessions.

Applied Behavior Analysis (ABA) Services

Behavior Identification Assessment: $150/hour billed in 15 minute increments: This service covers the administration of criterion-referenced behavioral assessments, observation, interview, data analysis, and development of a treatment plan. The time required for this assessment varies greatly between clients and types of behavioral intervention plans; therefore, an estimated cost for this service will be discussed with family or client during an initial, no-cost phone consultation lasting approximately 15 minutes.

Direct ABA Treatment: $50/hour billed in 15 minute increments: This service covers working 1:1 with the client or training of natural supports. The client must be present for these sessions. These sessions may include a combination of coaching, direct work with clients, data analysis, and protocol modification. If additional data analysis or protocol modification are required outside of session, this is billed separately using the Behavior Identification Assessment code.

Family Behavioral Therapy: $150/hour billed in 15 minute increments: This service covers meetings with caregivers of the identified client and may be conducted with or without the client present. The focus of this service is on planning and problem solving intervention, review of assessments and data, and training in behavioral techniques.

Phone consultations: $150/hour billed in 15 minutes increments: Phone calls lasting less than 15 minutes for the purposes of planning and scheduling are not billed to the family.

Preparation of Treatment Documents: $150/hour billed in 15 minute increments: Many of the treatments provided by staff at Beyond the Individual, LLC require extensive plan writing and data analysis to guide and update plans. For this reason, staff do charge for the preparation of documents and plans that are integral to the successful implementation of treatment by natural supports.

Travel: Provider hourly rate billed in 15 minute increments: With a majority of intervention provided in the natural environment, staff at Beyond the Individual, LLC are required to travel to see clients. When possible, staff will meet in an agreed upon private location, such as a private meeting room at a local library, or via telehealth to limit the costs of travel as indicated. The client may also be requested to cover the cost of lodging if an overnight stay is required for sessions or training with distance-based clients or teams.

Therapy Groups & Training

Beyond the Individual, LLC offers a variety of therapy groups focused on specific skills for both parents and children. These groups are offered based on availability and interest. In-person groups are generally held weekly or bi-weekly in-person or or via group telehealth. Participants are required to attend a one-hour screening session and complete a tutorial on group expectations prior to participation. Rates for screening sessions and groups are variable based on the assessments that need to be conducted to determine appropriate fit. Please check back regularly for a list of potential offerings. Groups are charged at an average rate of $25-75/session with participants required to attend all planned sessions or make-up missed sessions via video review.