Banner photo by Ruben Hopwood
Fees are Paid by each Client at the Time of Service
Both Hopwood Counseling & Consulting, LLC and Life Cycles Therapy
provide out-of-network services ONLY.
Read about the benefits of seeing an out-of-network provider here.
~insurance is not billed directly for any SERVICES~
Clients are responsible to check with their own insurance for out-of-network benefits. Use the information below: National Provider Identification (NPI) numbers, license level (doctoral or masters), service fees, and billing codes to help when talking to a carrier about possible reimbursements.
Clients who intend to seek insurance reimbursement for a portion of their out of pocket costs for treatment are responsible to verify that their insurance carrier will reimburse for out-of-network teletherapy services before incurring any costs.
Active clients receive regular documentation of services they receive and payments they make (a superbill and/or invoices). Clients are responsible for submitting superbills/invoices to their own insurance for reimbursement.
~All sessions are provided BY HIPAA secure video (teletherapy)~
VIDEO therapy services allow individuals anywhere within the states where the clinician is licensed to receive teletherapy supports while they are in that state.
Dr. Ruben Hopwood is a licensed psychologist in
Massachusetts (PSY10733), Minnesota (LP6971), and New Hampshire (4201).
Melanie Cohn-Hopwood is a licensed clinical social worker in
Massachusetts (LICSW113364), Maryland (LCSWC30345), and New Hampshire (3647).
Fees for Teletherapy Services by Provider
Hopwood Counseling & consulting, llc
Ruben HOpwood, MDiv, PHD, LP (NPI number: 1972859148)
**professional consulting and WPATH mentoring fees are individually arranged on request separately**
Psychotherapy (individual adults only) VIDEO THERAPY ONLY
$195.00 per 38-52-Minute Session (This is the default session length)
Billing Code 90834-95 (teletherapy)
$235.00 for 53-60-Minute Session (by prearrangement only)
Billing Code 90837-95 (teletherapy)
$250.00 for 60-Minute Intake/Psychiatric Diagnostic Evaluation
Billing Code 90791-95 (teletherapy)
Gender Affirming Surgical Evaluation & Referral*
$500.00 for 120-Minutes minimum (2 sessions)
Billing Code 90791-95 (teletherapy)
IF additional sessions are necessary, they are at the standard rates above.
*Please note that it is unethical and unprofessional for any clinician to guarantee a referral for any medical treatment prior to an evaluation by that clinician.
Life Cycles Therapy
Melanie Cohn-hopwood, licsw, LCSW-C (npi number: 1083857502)
Psychotherapy (individual adults only) VIDEO THERAPY ONLY
$165.00* per 50-Minute Session
*Time-limited reduced-fee sessions may be available, but are not promised.Billing Code 90834-95 (teletherapy)
$185.00 for 60-Minute Intake/Psychiatric Diagnostic Evaluation
Billing Code 90791-95 (teletherapy)
Gender Affirmation Medical Treatment (surgery) Assessments & Referrals
$375.00 for 110-Minutes (2 sessions)
Billing Code 90791-95 (teletherapy)
IF additional sessions are necessary, they are at the standard rates above.
Our commitments
We are committed to providing services that are clinically sound, ethical, and that model self-care, respect, and integrity.
We provide our clients with the best care we can offer safely, confidentially, and in a supportive environment.
We honestly disclose our fees before accepting anyone into services, providing written estimates of the expected cost of treatment to inform people’s free choices where to get services.
We model ethical care by following our own recommendations for self-care, personal responsibility, and healthy boundary-setting that we assist clients to learn and demonstrate in their own lives.
We strive to keep what we say and what we do in alignment.
We model charity, generosity, and support of communities in need through our private and charitable giving, volunteer work, and professional consultation and training for scores of health care providers and corporations nationally who then are enabled to provide sensitive and competent care and services to thousands more people than we could ever reach individually.
Common Fee Questions
Are these fees ever reduced?
Life Cycles Therapy may at times have time-limited reduced fee appointments available. Hopwood Counseling & Consulting, LLC does not have reduced fee appointments available. If you are not able to pay out-of-pocket fees for services, you have other options. You may check with referral sites such as Psychology Today, Zencare, Therapy Den, Better Help, and the Therapy Matcher service of the National Association of Social Workers. Most of these sites have ways to narrow down the service areas you want (e.g., LGBTQ, transgender, trauma, language preferred, etc.) and by insurance accepted. Some search engines are national, so make sure you are searching in the state where you need and/or will receive services. For Cambridge, Massachusetts residents, services may also be available through the Cambridge Health Alliance. You can also call the number on the back of your health insurance membership card and request a list of behavioral health providers who are in-network and who will accept your insurance as direct payment for services.
If you are unable to pay out of pocket or use health insurance to get evaluations and surgery referral letters, there may be clinicians in your area who provide these services pro bono (for free). Click here for a national list of clinicians who have agreed to provide free gender-affirming surgery referrals.
What do you mean you don’t take insurance?
The choice to provide only private-pay services is complex and based in part on economics as well as our commitment to privacy and access to care. Private payment for mental health treatment offers most clients a choice of increased privacy from third parties, such as insurance carriers, who might otherwise have access to know what issues people are working. Private-pay services also offer many clients the ability to determine when and for how long they choose to make use of services without external limits from insurance carriers or termination of coverage for services when benefit maximums or allotments are met.
There are no state or national caps on therapy fees and no regulations that mandate mental health professionals in private practice sign contracts with health insurance companies for payment of services or that they offer reduced rates. Rates for private-pay services customarily vary based on a number of factors including the cost of living in the region where services are provided. We choose to provide sustainable services to our clients that meet client needs to the best of our ability and which are competitive in the Boston metropolitan area where our primary practices are located.
Private-pay means we do not bill any health insurance plans for direct payment of the costs of services provided. We are not contracted providers for any insurance plans within any state or federally. This means that clients cannot pay a co-pay and then have their insurance plan pay the therapist a negotiated remainder for the service provided. Clients pay the full session fee* at the time services are provided. Payments are handled through an automatic charge to the client’s secure credit/debit card or FSA/HSA card which they enter into their health record on enrollment in services. Clients who have out-of-network benefits may, on their own, submit monthly provided superbills to their insurance for reimbursement of a portion of their session fees according to their own benefits. (see “How do Out-of-Network benefits work” below.)
All sessions must be paid in full on the day of service. Sessions that are attended, and all missed appointments and sessions cancelled with less than 24-hours notice, must be paid for in full at the time of the scheduled appointment. Payments are made by credit/debit card or HSA/FSA card. Auto-payments are arranged as part of the required registration process for individual treatment and contract for services.^
*Patients who pay out of pocket and who do not use insurance for reimbursement of health care costs have certain rights as of January 2022 to protect them from unexpected or excessive billing for services. Please check this page for more information on Good Faith Estimates and the No Surprises Act.
^Specific details of financial policies and payment responsibilities and expectations are provided to new clients at the time they contract for psychotherapy services and are part of the treatment agreement and registration packet.
How do Out-of-Network benefits work?
Many people submit paperwork (e.g., a superbill) documenting payments they made for services they have received to their insurance carrier for reimbursement. This is called “out-of-network” (OON) benefits. Clients must contact their own insurance carrier to ask whether they have OON benefits. These benefits are more common with PPO plans and are unusual with HMO or public plans. Clients are provided with a superbill each month from their therapist. This superbill lists the insurance billing codes (e.g., CPT codes—see above) for the services received, a diagnosis code for the primary condition the treatment addresses, and documentation of payments the client made for services received. Note that clients are not able to be reimbursed for missed sessions and late cancelation charges though these will appear on the superbills as well.
There is no information on a superbill that discloses what a client talks about in sessions or personal life details. The superbill will list the client’s name and date of birth as it appears on their health insurance so that reimbursement is not denied due to the carrier having no record of coverage for the person submitting the claim. Superbills list the diagnosis code to identify the primary reason the person is receiving therapy as well as the identifying information for who received the treatment and the National Provider Identifier number (NPI) and business address of the clinician who was the provider of these services.
You have the right to request out-of-network benefits when your insurance carrier does not have any therapists in-network who provide specialized care such as spiritually-integrative psychotherapy, assessments for gender affirming medical and surgical referrals, concerns specific to alternative lifestyles, etc. Additionally, with the permanent expansion in Massachusetts and other places across the country of psychotherapy benefits to include telemental-health (e.g., teletherapy), people living anywhere within the state where a therapist is licensed can access psychotherapy and specialty therapy services regardless of how close they live to a therapist’s office. This increases options available to many people who cannot travel to an office far away or who have no specialists in their home area who can address their unique needs.
Whether these out-of-network benefits are provided even when available, however, may vary and individuals are responsible to ask their insurance carrier about their benefits prior to engaging in services for which they may later want reimbursement.
How do I find out if I have out-of-network benefits?
Call the member services number on the back of your health insurance identification card and ask if you have “out-of-network benefits for behavioral health services.” If you do have OON benefits, ask them the rate of reimbursement, or how much they pay you back per session using for services using the codes listed above. This rate will vary based on the service you need and the level of degree and licensure of the therapist. This means that the reimbursement rate will be higher if the therapist is licensed at the doctoral level compared to reimbursement for a therapist licensed at the master’s level. For example, services at Hopwood Counseling & Consulting, LLC provided by Dr. Ruben Hopwood are at a doctoral level since he is a licensed psychologist. Services with Life Cycles Therapy, provided by Ms. Melanie Cohn-Hopwood, will be reimbursed be based on her master’s level license as a clinical social worker. The reimbursement rates will be different for each of these therapists and for each service code (see above).
I can’t afford to pay cash, but I want to see you!
It may feel frustrating that services you want are not available at reduced rates or through insurance plans. There are a range of strong emotions that come up when anything feels out of reach, especially when that thing is therapy and it feels like no one else could ever help. The disappointment can be a powerful feeling that may leave some people believing there is no one available to help them.
We have provided this page of information to help people explore what is possible using their own resources and reimbursement options, and when those options are not feasible, we have suggested resources to find low-cost supports though other service providers. Fortunately, there are many qualified therapists in Massachusetts and there are many community health centers, mental health agencies, and other clinics, which are registered non-profit organizations and have funding to supplement reduced client fees. Many non-profit health organizations receive state, federal, and private funding to allow them to offer subsidized and reduced rate services while financially supporting their businesses to offer low-cost, good care. The linked resources at the top of this page under “Are these fees ever reduced?” are a good place to look for reduced-rate, non-profit, subsidized, and insurance-based mental health providers and clinics.
