UPDATED Practice Policies 8/1/2025

PRACTICE POLICIES

APPOINTMENTS AND CANCELLATIONS

Please remember to cancel or reschedule 24 hours in advance. You will be responsible for a flat $200 cancellation fee should sessions be canceled in less than 24 hours. There is a 15-minute grace period for each session, after which the session will be deemed a no-show and will result in the full rate of the session. Due to HIPAA regulations, privacy, and confidentiality, client sessions must take place in a confidential and quiet therapeutic space. If the client’s location is not suitable for therapy, the session will be ended, marked as a late cancellation, and charged the full cancellation fee.

By signing this document, you consent to the card on file being charged. In the event of a dispute for late cancellation, no-show, or session charges, you agree to an additional $200 dispute charge. All further sessions will be canceled until the full balance on the account is cleared.

Session reminders are a courtesy of the practice but are the responsibility of the client. Concessions will not be made for missed sessions due to the lack of appointment reminders sent from the system.

The cancellation fee is strictly enforced.

The standard meeting time for psychotherapy is 53 minutes. It is up to you, however, to determine the length of your sessions. Requests to change the 53-minute session need to be discussed with the therapist so that time can be scheduled in advance.

A $50.00 service charge will be applied for any checks returned for any reason requiring special handling.

Despite insurance co-payment or co-insurance amounts, a less than 24-hour cancellation and no-call, no-show is not covered by insurance and will be charged the full cancellation fee. Cash rate clients will be charged 24 hours before the session. Clients on a sliding scale will also be charged the full cost of the session, not the sliding scale amount, in the event of a late-cancellation or no-show. Should a client’s insurance company not cover their session for any reason, the client agrees to be liable for the out-of-pocket cost for that session.

Again, cancellations and rescheduled sessions will be subject to a full late-cancellation charge if NOT RECEIVED AT LEAST 24 HOURS IN ADVANCE. This is necessary because a time commitment is made to you and is held exclusively for you. If you are late for a session, you may lose some of that session time.

You are required to have an updated card on file, despite having no co-payment or co-insurance.

FEE SCHEDULE (Updated 8/1/2025)

• 90791 Intake Session – Psychiatric Diagnostic Evaluation, 60 minutes: $275
• 90837 Psychotherapy, 55 minutes (Standard Session): $250
• 90834 Psychotherapy, 45 minutes: $200
• 90839 Psychotherapy for Crisis, 50 minutes: $350
• 90840 Crisis, additional 30 minutes: $250
• 90846 Family Therapy without patient present, 50 minutes: $275
• 90847 Family Therapy with patient present, 50 minutes: $275
• 90853 Group Therapy, 50 minutes: $160 per person per session
• 90875 Other Psychiatric Services or Procedures, 50 minutes: $150
• 96130 Psychological Testing, Evaluation, first 50 minutes: $350
• 96131 Psychological Testing, Evaluation, each additional hour: $300
• 96136 Psychological Test Administration and Scoring, first 30 minutes: $250
• 96137 Psychological Test Administration and Scoring, each additional 30 minutes: $200
• 00005 Document Preparation, every 30 minutes: $150

The minimum charge for a court appearance is $2000 and $500 per hour (additional charges will incur if court exceeds 3 hours). A retainer of $2500 is due in advance. If a subpoena or notice to meet with attorney(s) is received without a minimum of 2 weeks’ notice, there will be an additional $250 “express” charge. If the case is reset with less than 1 week’s notice, the client will be charged $500 (in addition to the minimum retainer of $1500 plus $500 for every additional hour over 3 hours).

Clients with deductibles will be responsible for the insurance contracted rate that Turntable Counseling, LLC has with their insurance provider until the deductible is met. At that time, all co-payment and co-insurance amounts will apply. Your intake session and standard session costs will be discussed with you when you schedule your session.

If there is an agreed-upon sliding scale rate, this rate will only apply for sessions and not for no-shows or late cancellations, to which the full no-show/cancellation fee will apply.

If the client’s insurance returns after the session is held and states that the client does not have mental health coverage, the client is responsible for the full out-of-pocket cost of the session.

TELEPHONE ACCESSIBILITY

If you need to contact me between sessions, please leave a message on our voicemail. We are often not immediately available; however, we will attempt to return your call within 24 hours. Please note that face-to-face sessions are highly preferable to phone sessions. However, if you are out of town, sick, or need additional support, phone sessions are available. If a true emergency arises, please call 911 or any local emergency room.

SOCIAL MEDIA AND TELECOMMUNICATION

Due to the importance of your confidentiality and minimizing dual relationships, we do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc.). We believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet, and we can talk more about it.

ELECTRONIC COMMUNICATION

We cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email or text messaging for scheduling or cancellations, we will do so. While we may try to return messages promptly, we cannot guarantee an immediate response and request that you do not use these methods to discuss therapeutic content or request emergency assistance.

Services by electronic means, including but not limited to telephone communication, the internet, facsimile machines, and email, are considered telemedicine by the State of California. Under the California Telemedicine Act of 1996, telemedicine is broadly defined as the use of information technology to deliver medical services and information from one location to another. If you and your therapist choose to use information technology for some or all of your treatment, you need to understand that:

1. You retain the option to withhold or withdraw consent at any time without affecting your right to future care or treatment or risking the loss or withdrawal of any program benefits to which you would otherwise be entitled.
2. All existing confidentiality protections are equally applicable.
3. Your access to all medical information transmitted during a telemedicine consultation is guaranteed, and copies of this information are available for a reasonable fee.
4. Dissemination of any identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent.
5. There are potential risks, consequences, and benefits of telemedicine. Potential benefits include, but are not limited to, improved communication capabilities, convenient access to up-to-date information, consultations, support, reduced costs, improved quality, changes in the conditions of practice, improved access to therapy, better continuity of care, and reduced lost work time and travel costs.

Effective therapy is often facilitated when the therapist gathers, within a session or series of sessions, a multitude of observations, information, and experiences about the client. Therapists may make clinical assessments, diagnoses, and interventions based not only on direct verbal or auditory communications, written reports, and third-party consultations, but also on direct visual and olfactory observations, information, and experiences.

When using information technology in therapy services, potential risks include, but are not limited to, the therapist’s inability to make visual and olfactory observations of clinically or therapeutically relevant issues such as your physical condition (including deformities, apparent height, weight, body type, attractiveness relative to social and cultural norms or standards, gait and motor coordination, posture, work speed, any noteworthy mannerisms or gestures), physical or medical conditions (including bruises or injuries), basic grooming and hygiene (including appropriateness of dress), eye contact (including changes in the previously listed issues), sex, chronological and apparent age, ethnicity, facial and body language, and congruence of language and facial or bodily expression. Potential consequences thus include the therapist not being aware of what they might consider important information that you may not recognize as significant to present verbally to the therapist.

MINORS

If you are a minor, your parents may be legally entitled to some information about your therapy. We will discuss with you and your parents what information is appropriate for them to receive and which issues are more appropriately kept confidential. By signing the contract document and placing a card on file, you are consenting to all financial responsibilities associated with services and fees for services and missed sessions.

TERMINATION

Ending relationships can be difficult. Therefore, it is important to have a termination process to achieve closure. The appropriate length of termination depends on the length and intensity of treatment. We may terminate treatment after an appropriate discussion with you and a termination process if we determine that psychotherapy is not being effectively used or if you are in default on payment. We will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose for terminating. If therapy is terminated for any reason or you request another therapist, we will provide you with a list of qualified psychotherapists. You may also choose someone independently or from another referral source.

Should you fail to schedule an appointment for three consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons, we must consider the professional relationship discontinued.

RESIDENCE IN THE STATE OF MARYLAND

Clinicians at Turntable Counseling, LLC are primarily licensed in the State of Maryland. Per best practices, COMAR regulations, and state laws governing the professional licenses held by the clinicians at the practice, all clients, including telehealth sessions, must be located within the state limits of Maryland to receive services. It is the client’s responsibility to make the clinician aware of their physical location during telehealth sessions, as the clinician can only document per the client’s report.

By signing this document, you agree that all telehealth sessions will be held while you, the client, are within the State of Maryland. Should you be traveling or not within Maryland, you agree to notify your clinician at least 24 hours prior to your session so it can be immediately canceled, or it will be subject to the cancellation fee.

All clients must agree to and maintain agreement to these policies to begin and continue services.

ALL CLIENTS AGREE THAT IT IS THEIR RESPONSIBILITY TO REVIEW ALL UPDATED PRACTICE POLICIES AND PROCEDURES LISTED ON THE WEBSITE, AS THEY MAY CHANGE.

www.turntablecounseling.com