We currently accept the following insurance providers for our psychotherapy services:
- Blue Cross Blue Shield
- Tricare/Humana Military
- United Healthcare/Optum
Out-of-pocket/ Self-pay Rates:
- Initial Intake (60 minutes): $150
- 60 Minute Session: $120
Session w/ Intern or Practicum Student:
- 60 Minute Session: $50
**If you currently have a policy through an insurance entity that is not listed, please contact our office at 252-232-8086 to see what options may be available to you.
PACKAGE SPECIAL: $525
- 4 Personal One-on-One Sessions with Knowledgeable Therapist & SYMBIS Instructor ($510 value)
- 15 Page Relationship Analysis ($15 value)
- In-depth Assessment Utilizing Renowned SYMBIS Program ($35 value)
- His & Her Workbooks ($22 value)
- Saving Your Marriage Before it Starts Book By: Dr. Les and Leslie Parrott ($23 value)
Total Value: $725- This is a savings of $200!
Mindfulness Meditation Massage Session:
Mindfulness Meditation Massage Session:
Mindfulness Meditation Massage Session:
Buy 3 sessions in advance, get your FOURTH ONE FREE!
Good Faith Estimate
Payment is due at the time of service. Peaceful Waters accepts cash, check, money orders, FSAs, HSAs, and credit cards. In the event that you pay by check and the check is returned, a $30 fee will apply.
Balances must be paid in full before future appointments can be scheduled. If you have an unpaid balance on your account, Peaceful Waters holds the right to cancel any future appointments until payment is made.
An initial assessment/intake is $150 (self-pay). Each following session is $120 (self-pay). These fees are for individuals who do not have health insurance or are covered by an out of network policy.
In addition to offering a self-pay rate, the majority of our providers are also in-network with Blue Cross Blue Shield, Tricare/Humana Military, United Healthcare/Optum, Aetna, Cigna/Evernorth, Optima, Humana, and MedCost insurance plans. Your copay will depend on your specific insurance plan and deductible that may or may not need to be met. The CPT codes typically billed to insurance for Psychotherapy Sessions are 90791 (Intake/Assessment) and 90837 (53-60 minutes of care). For additional information on copays for mental health/behavioral health counseling, please contact your insurance provider. While our office is sometimes able to give an estimate for the cost of care based on your plan, these quotes are not a guarantee. Our practice does NOT accept Medicaid or Medicare plans at this time.
If your insurance carrier is not listed above, you may request a "superbill" at your time of service to submit to your insurance carrier for potential out-of-network reimbursement. Please contact your insurance company for directions on how to best submit this information.
In the event that you are utilizing our self-pay option and need to terminate or leave a session early, you will not be refunded your fee or any portion thereof. In the event of a crisis or we agree that a session needs to go over our allotted time, you will be charged at a rate of $2/minute.
In the event that you are utilizing insurance and need to terminate or leave a session early, we are legally not allowed to bill for that session in its entirety. Therefore, you may be required to pay for your session at the full self-pay rate. Please make sure to schedule accordingly, so that you can take advantage of a full therapeutic hour. In the event of a crisis or we agree that a session needs to go over our allotted time, you may be charged at a rate of $2/minute. This fee may or may not be covered by your insurance.
Other fees that may apply:
1. For personal phone calls and messages to your provider (i.e. email and/or text) outside of a regular scheduled session, there is a $2 per minute fee. This fee also applies for lawyers, family members, doctors, etc. that you are requesting information to be relayed to, and in which there is an appropriate Release of Information form on file.
2. There will be a $25 fee for requested letters or documents that require less than 30 minutes of your provider's time. There will be a $50 fee for letters documents that require 30-53 minutes of your provider's time. For letters or documents requiring more than 53 minutes of your provider's time, you will be billed at the standard hourly rate of $120.
3. If a document and/or records must be filed with a court/attorney entity, an initial fee of $50 shall be assessed.
If the time that it takes to submit such documents and/or records exceeds 30 minutes, the standard hourly rate of $120 shall be assessed. The same fees apply to requests for documentation to file for disability, FMLA, or to have a clinical case summary prepared.
4. In the event that records are subpoenaed and court testimony, deposition, and/or otherwise is required, compensation will be given to cover time to appear, prepare necessary documents, and travel. By signing below, I understand that no staff or affiliates of Peaceful Waters Counseling and Wellness Center, PC will testify, appear, give expert witness, or otherwise without a direct order from the court. If requested or subpoenaed to appear prior to noon, then an 8-hour minimum fee of $800 shall be prepaid. If requested or subpoenaed to appear after noon, then a 4-hour minimum fee of $400 shall be prepaid. In the event that the provider is required to be present for additional days waiting for his or her testimony to be given, each day of waiting is charged at the same rates. Travel outside of a 25-mile area of Moyock, NC will be charged at approx. $2/minute of the
provider’s time. Additional expenses such as hotel, taxi, meals, printing records, etc. will be the responsibility of the client and are in addition to the daily charges delineated above. If a subpoena or notice to meet with an attorney or court legality is received without a minimum of 48-hour notice, there will be an additional $250 “express” charge. If a court date is cancelled within 24 hours, a fee of $150 will be charged.
5. Court/notary/postage fees, pertaining to a Release of Information shall be assessed in their entirety.
6. For printed, copied, and/or scanned documents, a $1/page fee shall apply.
7. Travel time and/or preparation associated with a Release of Information shall be assessed at $2/minute.
8. In the event that any staff member or affiliate of Peaceful Waters Counseling and Wellness Center, PC must seek legal consultation or representation and/or incurs any attorney fees/costs as a result of information pertaining to a Release of Information, the authorizing party shall be responsible.
Duration of Care: Due to the nature of counseling, individual needs, presenting diagnoses, client compliancy in treatment, differing worldviews, pre-existing traumas, life changes that may present themselves during the course of care, openness to change, and other various factors, we are unable to give clients an exact estimate of how long it will take to complete treatment. For some it may be one to three sessions. For others, it could be a year or more. All providers with Peaceful Waters will do their best to let clients know during the first couple of sessions what they recommend in regards to frequency of sessions and how long it might take to work through the presenting issue(s) at hand.
PLEASE NOTE: This is a very strict late cancellation/no show policy. Any appointment that is not cancelled with at least 24 hours notice will be charged the $120 fee ($50 for practicum students and interns). Your insurance company DOES NOT cover this fee. While we understand that there are times when you must miss an appointment due to an emergency, cancelled appointments may prevent other patients from getting much needed treatment and care. Therefore, in the event that you must cancel, 24 hours notice MUST be given. We understand that this policy is quite strict, especially in the event of an emergency. Therefore, we will be implementing a one-time fee reduction for late cancellations/no shows. This fee is $60 for Providers and $25 for Practicum Students/Interns. If you have already received a waiver or fee reduction with our practice, you will not receive an additional one. Thank you for your understanding! This policy is in alignment with other private practices and ensures that the therapeutic commitment is taken seriously and our highly trained providers are compensated for their time.