- Blue Cross and Blue Shield
- United HealthCare/Optum Behavioral Health
- Tricare Select
If you are not interested in utilizing your health insurance or are currently uninsured, we offer self-payment options.
Good Faith Estimate
All self-pay clients are entitled to receive a Good Faith Estimate of what the charges could be for services provided to you from Temple Builders, LLC. This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service.
This estimate is not a contract and does not obligate you to obtain any services from the provider(s) listed, nor does it include any services rendered to you that are not identified here.
The estimate is based on information known at the time the estimate was created. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. There may be additional items or services I may recommend as part of your care that must be scheduled or requested separately and are not reflected in this Good Faith Estimate. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.
You have the right to initiate a dispute resolution process if the actual amount charged to you substantially exceeds the estimated charges stated in your Good Faith Estimate (which means $400 or more beyond the estimated charges). You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill or ask if there is financial assistance available. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120
calendar days (about 4 months) of the date on the original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.
For questions or more information about your right to a Good Faith Estimate or the
dispute resolution process, visit https://www.cms.gov/nosurprises/consumers or
call 1- 800-985-3059. The initiation of the patient-provider dispute resolution
process will not adversely affect the quality of the services furnished to you.
Graduate Level Clinician
- Individual Therapy: $100 – $130
- Couples Therapy: $125 – $155
- Family Therapy with three or more members: $150 – $180
- Telephone calls between 16 and 30 minutes: $50 (Not Covered by Insurance)
- Telephone calls between 31 and 60 minutes: $100 (Not Covered by Insurance)
- 60-minute crisis session (Individual): $150
- 60-minute crisis session (Couples): $180
- 60-minute crisis session (Family): $200
Clinical Level Clinician
- Individual Therapy: $150 – $180
- Couples Therapy: $200 – $230
- Family Therapy with three or more members: $230 – $250
- Telephone calls between 16 and 30 minutes: $75 (Not Covered by Insurance)
- Telephone calls between 31 and 60 minutes: $150 (Not Covered by Insurance)
- 60-minute crisis session (Individual): $200
- 60-minute crisis session (Couples): $250
- 60-minute crisis session (Family): $270
- Clinical Supervision: $100
- Clinical Consultation: Price is determine based on services being requested.
- All major credit cards and cash are accepted.
- Payment will be processed at the time of your appointment and after any insurance adjustments.
- We do not accept checks or cash app cards.
No Show/Cancellation Policy
We understand there are times when you cannot attend your scheduled appointment due to unforeseen events. If you are unable to attend your scheduled appointment, we ask that you call to cancel and reschedule your appointment within 24 hours of your scheduled appointment.
If you are unable to cancel within 24 hours or you are a no show for your scheduled appointment, you will be required to pay an $80 fee for the missed appointment.
This fee will be charged to the credit card on file on the day of your appointment.