Schedule of Fees

• 50-60 minute therapy session: $160

• Late Cancellation (within 24 hours of scheduled session): $160

• Cancellations with more than 24 hours notice: $0

• Returned check fee: $10

• Court prep fee: $200 per hour

• Court fee: $200 per hour with 2 hour minimum if not settled 48 hours in advance

• Medical Records Request: $160 per hour

• Completion of Documents excluding court preparation i.e. disability, letters, etc.: $140 per hour

• Consultation (IEP, coordination of care, family meetings): $140 per hour

• Subpoena (request to testify): $200

You may be advised to purchase books to aide in your therapy. Those purchases are made through other bookstores such as Barnes and Noble and Amazon or others. I do not receive compensation for those purchases, and you may choose whether or not to use them to aid your therapy. Additionally, any recommended supplemental books are completely optional; you do not need to purchase anything else.

Your right to a good faith estimate

In compliance with the No Surprises Act (NSA) that went into effect January 1, 2022, we are required to notify all healthcare consumers of your federal rights and protections against “surprise billing,” or unanticipated medical bills.

This act requires that we notify you of your federally protected rights to receive a notification when services are rendered by a non-participating provider and provide options to receive care from an in-network provider if one is available. I am out of network with insurance. You may choose to use another provider for therapy. Additionally, we are required to provide you with a Good Faith Estimate of the cost of services for the duration of treatment. It is difficult to determine the true length of treatment for mental health care. As a strength-based and client-centered practice, we empower our clients to determine their own course of mental health treatment, including, but not limited to: frequency of treatment, choice of clinician and length of service.

You are entitled to a Good Faith Estimate:

• No less than 3 business days before the scheduled service if scheduled within 10 days of service,

• No less than 24 hours before the service if scheduled within 3 days of service, 

• Prior to committing to a treatment agreement,

• Upon your request, within 3 business days of request. 

You may, at any time and without penalty, request a new Good Faith Estimate.

What is in a Good Faith Estimate?

Your Good Faith Estimate includes:

• Description of anticipated services

• Outline of any potential charges

• Diagnosis and service codes

• Estimation of treatment time

• Necessary disclaimers

If you are having trouble reading or understanding your Good Faith Estimate, I will gladly walk you through it so that we are both on the same page.

What if the bill I receive is different from the Good Faith Estimate?

During your treatment with Weiler Counseling LLC, you may request a new Good Faith Estimate at any time. We may discuss your care and you may choose to extend treatment or increase or decrease the frequency of your therapy sessions. I am also available for additional sessions between scheduled session which will also change the outcome of your billing. Weiler Counseling LLC. will also be able to provide updated Good Faith Estimates upon your request.

If your billing is more than $400 different from the estimate(s) you have received, you may contact: The State of Colorado at help@cohealthinitiative.org or https://www.cms.gov/nosurprises/Ending-Surprise-Medical-Bills

What if I disagree with my Good Faith Estimate?

Receiving your estimate does not mean that you are committing to receive care from me. You have the right to seek care from another provider for any reason at any time. If you do not agree with or approve of the terms and conditions in your provided estimate, you may decline care without penalty.

To receive your own Good Faith Estimate, contact Kari Weiler at (303) 909-0177.