PATIENT FEE SCHEDULE

Revised MARCH 2025

Self Pay Appointments:

• New Patients $325.00

• Initial Follow Up Visits $135.00/visit

• Suboxone Patients $375.00

• Suboxone Follow Up Visits $165.00/visit

• Spravato/Sublocade TBD

Integrative assessments for cognitive evaluations: $97.00/test

Advisory: All new and established patients are billed separately for this integrative assessment, in addition to their insurance plans or, if uninsured, as a self-pay service. Payment is required prior to administering the assessment.

Administrative Services:

• Excuse Notes for School/Work – No Charge

• Patient Records starting at $35.00 + $1.00/pg after the first 25pgs.

• Patient Letters starting at $35.00+ (pending type/complexity of patient history)

• ESA Letters (Emotional Support/Service Animal) $85.00/annually

• Disability Forms and FMLA Forms starting at $150.00+ (pending complexity)

• Peer Reviews starting at $175.00+ (pending complexity)

• Accommodation Letters $150.00 (504, IEP, etc.)

• Prescription Refills Request $35.00/Rx (must have provider approval)

NOTE: Controlled medications DO NOT get filled- NO EXCEPTIONS!!!