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Insurance information & fees

Behavioral and mental health services

Committed to providing quality, reasonably priced care to all families.

We’re proud to accept Fidelis Care, Healthfirst and Point Comfort behavioral health insurance coverage in New York, and are actively working towards becoming a participating provider with other insurance companies. We also participate in the MultiPlan network, which may give you access to contracted providers at a discounted rate.

For patients whose insurance we do not currently accept:

  • When booking an appointment, you will be asked to provide a credit card.
  • Our team will provide receipts and can assist in the process of submission to your insurance company and/ or HSA account.
  • After reimbursement*, many patients say that they pay just $40 per visit, on average!
  • We encourage you to check with your insurance provider to understand if behavioral health is eligible for coverage through reimbursement.

*Not available for parent and sleep coaching

**CPT codes can be provided to your insurance company to determine out-of-network benefits.

Appointments canceled within 24 hours may be subject to full cost of service.

Fees reflect the “Prompt Pay Discount”
Service
Fee
CPT Code**
Initial evaluation:
$250
90791
Individual and family therapy:
$150-$250 (based on complexity and length of visit)
90834-37
Medication management with psychiatrist, pediatrician, or nurse practitioner:
$200-$500 (based on complexity and length of visit)
99203-99205 (first visit) | 99213-99215 (follow-up visit)
Group therapy:
$75
90853
Sleep or parent coaching:
$150 (initial visit) | $150 (60-minute follow-up visit) | $75 (30-minute follow-up visit)
0591T (first visit) | 0592T (follow-up visit)

Submit a claim to your insurance for reimbursement in 3 easy steps:
1. Look for your receipt/statement from PM Pediatric Care (we will email you one monthly)
2. Submit a claim to your insurance company directly
3. Receive your reimbursement payment

Behavioral Health: Now Participating in MultiPlan

In our continued commitment to provide affordable and accessible care, we are pleased to announce that our behavioral health services now participate in the MultiPlan network, which may give you access to contracted providers at a discounted rate.

How it works:

• During your appointment, you will need to provide your commercial insurance information.

• After your appointment, we will submit a bill to your commercial insurance company.

• When your insurance company returns the paid claim to us, we will assess if there is any additional cost to you. The difference between their reimbursement and our prompt pay rate is your out-of-pocket charge. If there is a remaining balance, we will bill your credit card on file.

• Due to varying insurance contracts, we will not know the remaining balance until after submission. The maximum out-of-pocket fee that you will owe is our established prompt pay discount rate.

look for multiplan logo on your commercial insurance card

Billing questions?

Call 888-764-4161 and select Option 3 to speak with our billing department.

Visit our main Behavioral Health page to learn more about how we can support the mental health of you and your family.

Looking for insurance information for a PM Pediatric Urgent Care Office?