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Fees and Insurance

Lux Psychiatry is not in network with any insurance company. Therefore, we do not receive payment directly from the insurance company.​ 

 

Services are paid for in full by the client at the beginning of each session via credit card or bank transfer.

  • Our fee for initial Psychiatric Evaluation is $365

  • Follow up medication management appointments range from $200-285 per session.

 

​​Dr. Hidalgo will provide you with an invoice/receipt or “superbill” which you can present to your insurance provider in order to seek reimbursement.

 

We cannot take payment directly from Medicare/Medicaid recipients.

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Planning to Use 
Insurance Benefits?

If you plan to use your insurance benefits, it is in your best interest to check with your insurance provider prior to your first appointment in order to understand the full details of your out-of- network mental health benefits.

 

Some questions to ask include:

​- Do I have out of network benefits?

- Do I have a deductible? If so, how much is it?

- How much would I be reimbursed for the visits? (Ask about the CPT codes listed below)

- Is there a limit on the amount of visits I can have?

- How do I submit invoice to get reimbursed for the visit?​

Not Using 

Insurance Benefits?

If you do not plan on using your health insurance, or are uninsured, you are entitled to a Good Faith Estimate explaining how much your medical care may cost.  

 

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the Helpdesk Line at 1-800-985-3059. 

Commonly Used CPT Codes

  • Initial Psychiatric appointments (60 min): CPT code 90792.95

  • Follow Up appointment medication management only (30 min): CPT code 99214.95 + 990833.95

  • Follow Up appointment medication management only (15 min): CPT code 99213.95

  • Follow Up appointment medication management + psychotherapy (50 min): CPT code 99213.95 + 90836.95

  • Psychotherapy only appointments (50 min): CPT code 90837.95

  • Psychotherapy only appointments (25 min): CPT code 90832.95

  • Consultation for PCP or second opinion (60-90 min): CPT code 90792.95 or 99205.95

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