This brochure provides key details about your insurance coverage, billing process, and the mental health services at River Valley. Understanding your insurance benefits, copays, deductibles, and how coverage works will help you navigate costs and know what to expect financially. Additionally, knowing the various procedure codes and therapy services will assist you in understanding the treatments and the time spent during sessions. By being informed, you can manage your appointments and payments with more confidence, ensuring a smoother experience throughout your time at River Valley.

Contact Information

• Scheduling Questions: 952-746-7664 or mail@rivervalleybhwc.com

• Billing Questions: 952-746-0583 or billing@rivervalleybhwc.com

Mandated Reporting 

In Minnesota, mental health therapists are legally required to report suspected abuse or neglect of vulnerable individuals (like children, elderly adults, or those with disabilities).

• When: Immediately, if abuse or neglect is suspected.

• What: Any sign of harm or risk to the person.

• Who: Report to authorities like child protective services or law enforcement.

• Why: To protect vulnerable people from further harm.

Failure to report can lead to legal consequences for the therapist.

Insurance Terms

• Insurance Coverage: What your insurance will pay for—this includes the types of treatments, therapies, and providers that your insurance plan will help pay for. Coverage doesn’t mean your insurance will pay for the entire cost of your care. It simply refers to what types of services your insurance will help pay for. You may still need to pay part of the cost, depending on your plan.

• Benefits: The mental health services your insurance covers, like how many therapy sessions you can have or what type of treatments are included.

• Copay: A fixed amount you pay for a service. Example: $20 copay for a therapy session. You pay this amount at each visit.

• Coinsurance: The percentage of the cost you pay after meeting your deductible. For example, if your insurance covers 80%, you pay the remaining 20%.

• Deductible: The amount you must pay out-of-pocket for services before your insurance starts covering costs. For example, if your deductible is $500, you pay that amount before insurance kicks in.

• In-Network: Providers (like therapists or doctors) that have agreements with your insurance, meaning they accept your plan and you pay less out-of-pocket.

• Out-of-Network: Providers that don’t have agreements with your insurance. You may have to pay more for their services, or your insurance might not cover them at all.

• Client Responsibility: It’s your responsibility to understand your insurance plan and benefits.

• Contact your insurance company to find out what services are covered and what costs (copays, deductibles, coinsurance) you may owe.

• River Valley cannot legally explain your insurance benefits or predict your costs after your claim is processed.

• To know your exact costs, always check with your insurance provider directly.

Billing & Payment Process Overview

1. Scheduling & Intake

• Schedule Your Intake: Book your intake appointment.

• First Two Sessions: These are billed as intake sessions.

• Required Paperwork: Complete all necessary paperwork before your first appointment.

• Credit Card on File: A credit card is required to be on file.

2. Insurance & Payment

• Understand Costs: Contact your insurance provider to know your potential costs.

• First Appointment Payment: Your card will be charged for any copay on the day of your first appointment.

• Private Pay Clients: Full payment is required upfront if you’re not using insurance.

• Insurance Submission: After the appointment, your provider will submit the session to insurance for processing (may take 5-90 days).

3. Payments & Billing

• Payment Due at Service: Copays, deductibles, and other charges are due when services are rendered.

• Credit Card Requirement: A credit card is required for all payments, even if you use an HSA card.

• Payment Processing: Payments are processed on the 15th and 30th of each month.

• Declined Payments: If your card is declined, services will be put on hold until payment or a payment plan is established.

• Balance Limits: A $300 balance limit is enforced. Accounts over $300 and 30+ days past due will incur a 2% interest charge.

4. Statements & Notifications

• Balance Notifications: You’ll receive text/email notifications every Monday if you haven’t received one in 14 days.

• Paper Statements: Available upon request, but text/email notifications are the default.

• Payment Links: Use the links provided in the notifications to pay your balance.

• Balance Changes: Payments will reflect the most recent balance notification, which may change based on insurance processing.

Therapy & Psychiatric Rates

• Initial Therapy Intake (2 sessions): $275 – $310 each (depends on age/complexity)

• Individual Psychotherapy: $175 (45 min) – $250 (60 min), extra charges for complexity

• Assessment/Testing: $225 per hour (includes materials, scoring, and reports)

• Group Therapy: $50 – $75 per 60-minute session

• Professional Consultation: $250 per 60 minutes

• Psychiatric Diagnostic Assessment: $300 – $615 (based on age/complexity)

• Psychiatric Medication Management: $150 – $300 (based on age/complexity)

• Brief Follow-Up (RN): $50

• Phone Calls, Reports, Letters: $250 per hour (not insurance-covered)

Standard Codes for Therapy and Psychiatric Services

• 90785 – Psychiatric Procedure, Interactive Complexity

• 90832 – Psychotherapy, 30 minutes

• 90834 – Psychotherapy, 45 minutes

• 90837 – Psychotherapy, 60 minutes

• 90839 – Psychotherapy for Crisis, 60 minutes

• 90846 – Family Therapy without the patient

• 90847 – Family Therapy with the patient

• 90853 – Group Therapy

• 90791 – Psychiatric Diagnostic Evaluation

• 90792 – Psychiatric Diagnostic Evaluation with Medical Services

• 99204-99205 – Office or Other Outpatient Visit (New Patient, High Complexity)

• 99211-99215 – Office or Other Outpatient Visit (Established Patient)

• 90833 – Psychotherapy, 30 minutes with E/M (Evaluation and Management)

• 90836 – Psychotherapy, 45 minutes with E/M (Evaluation and Management)

• 90838 – Psychotherapy, 60 minutes with E/M (Evaluation and Management)

• 99354 – Prolonged Service (with direct patient contact)

• 99417 – Prolonged Service with Direct Patient Contact

• 99422 – Online Digital Evaluation and Management (E/M) Service, 30 Minutes

• 99455 – Workplace Evaluation and Management (E/M) Service, with Report

• 96101 – Psychological Testing (by a Psychologist)

• 96130-96137 – Psychological or Neuropsychological Testing

• 96372 – nursing injection

Cancellation Policy

•  A 24-hour notice is required to cancel appointments without charge. Saturdays, Sundays, and holidays are excluded. For a Monday appointment, call by Friday at the same time.

• The first 2 missed appointments (late cancel/no show) incur a $100 charge each for therapy or medication management.

• After the first 2 missed appointments, the full fee is charged (e.g., $250 for 60-minute therapy, $225 for 30-minute medication management).

• Clients under medical assistance are allowed 3 missed appointments per year; after that, they will be referred to other providers.

• Intake appointments (established clients) incur a $150 charge, and missed nurse visits incur a $25 charge.

• Fees must be paid before the next scheduled appointment or will be charged to the card on file on the 15th or 30th of the month.

• Hospitalization is an exception to this policy.

To cancel an appointment: Call: 952-746-7664 or Email: mail@rivervalleybhwc.com