Fees & Forms

Fees

My fee for individual psychotherapy is $150 for a 50-minute hour.

For couples work, my fee is $200 for a 50-minute hour.

First session rates include intake and assessment, and are $170 for individual and $220 for couples.

Payment methods accepted in the office are cash, check or with a credit card. A small processing fee is added when paying with a card in the office.

If patients wish to pay by credit card from home before or after a session, this can be done via this website on the “Make a Payment” page. A small processing fee is charged when payments are made on the website.

Payments are also welcome directly from your Paypal account to mine via “friends and family” to my email mariomp@me.com.

My fees and policies (including session cancellation policy) are included in the “Consent for Treatment” form which all new patients sign when we start working together.

I believe in helping people find the help and support they seek in a way that fits their life situation. If you want to request a “sliding fee” consideration, please contact me and be prepared to explain your situation.

I will do my best to work with your situation, and if I cannot, I will be glad to share with you referrals to colleagues and relevant community resources.

Third Party Insurance

I am not an in-network provider for any insurance panels.
For insurance companies, I am considered an “out-of-network provider.” This means I will not seek reimbursement directly from them for the services I provide you. You can be reimbursed by them, though, and I can help you do this. I am used to providing my patients with a “super-bill” which is like an invoice with all the information that the insurance company will require to reimburse you for a portion of the amount you have paid. I cannot guarantee or predict what or when you will be reimbursed, but I can give you some tips and share my experience. Tell them my practice name, Mario Prietto LCSW, so you can be sure they recognize me as a provider. Ask about your deductible, limits for numbers of sessions, different coverage for different illnesses/diagnoses, and the timeframe for reimbursement.

New Patient Forms

Here is where prospective patients can download forms which will help make our first session possible. If we have scheduled an appointment, please print all relevant forms, fill them out, and bring them to your first session.

1. Adult Intake Form. If the client is a couple, then I ask that both members of the couple fill out their own Intake form.

Adult Intake Form   adult-intake-jan-2016

2. Child Intake Form. If the patient is under 18, this form should be filled out by the patient.

Child Intake Form    child-intake-march-2016-english

3. Consent for treatment. Every patient is asked to read and sign one of these before we can start work. A copy can be printed from this site at any time, or patients can ask me for a copy. This serves as our contract. It spells out limits of confidentiality, HIPAA compliance, and the rates I charge for my services.

Consent for Treatment   consent-for-treatment-jan-2016