Sliding scale fee - income based fee

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Counseling Fees and Payment Policies

The services provided by Dynamic Growth Counseling LLC (DGC) are performed by master’s level counselors and/or who are licensed by the State of Indiana. A standard session time is 53 minutes.

INSURANCE: If you have insurance that includes Mental Health Benefits, the initial intake session and/or yearly evaluation will be billed at $200, and each session thereafter will be billed at $150. You will be responsible for the remaining amount not covered under your Mental Health Benefits. The insurance benefits quoted by your insurance company and/or DGC are not a guarantee of payment. Please note that benefits can change periodically and may affect the amount that your insurance company will pay. The final confirmation of your benefits and copay will appear on the Explanation of Benefits you receive from the insurance company.

SLIDING SCALE: For clients who do not have insurance or choose not to bill services through insurance, a sliding scale fee based on the client's annual household income may be offered. An additional $20 will be billed for the initial session and yearly intake.

Proof of income must be provided to determine and set the session fee (i.e., a current tax return or the three most recent pay stubs). Clients should report any changes to income and provide supporting documentation. Clients must provide their proof of income via mail, email, fax, or in person before or at their first appointment. If proof of income is not received by the first appointment, clients will be charged $80 for the initial session. Clients will not be able to reschedule until proof of income is provided.

Annual Household Income Fee:

• Under $20,000: $60
• $20,001-$25,000: $65
• $25,001-$30,000: $70
• $30,001-$35,000: $75
• $35,001-$40,000: $80
• $40,001-$50,000: $85
• $50,001-$60,000: $95
• $60,001-$70,000: $100
• $70,001-$80,000: $110
• $80,001-$90,000: $120
• $90,001-$100,000: $130
• Over $100,000: $150

PAYMENT: Payment for counseling is due at the time of your counseling session. No cash will be accepted. We accept Visa, MasterCard, and Discover. If you miss two payments, we will not be able to reschedule you until we receive your full payment.

SESSIONS and CANCELLATIONS: It is very important to let us know at least 24 hours in advance if an unexpected conflict arises with your appointment time. If you have three late cancellations or no-shows within 3 months, you may be terminated as a client. You may be charged your normal session fee for late cancellations. You may be charged the full fee for no-shows if you have insurance. Missed appointments cannot be filed with insurance. In emergencies, i.e., unexpected weather, you will not be charged.

ADDITIONAL CHARGES (These fees are not billable to insurance or Medicaid):

• Court: The charge is $175/hr port to port with a minimum of one hour. After one hour, it is billed in 30-minute increments. A $350 retainer fee is required.
• Report Writing: When a report is requested, the client will be billed $75.