Fee Schedule

June 1, 2018

Subset of Fees for Peter Forster, MD

Note: Some sessions consist of 2 or more CPT codes

Medical Evaluation & Management CPT Code Fee
Established Patient 10 minutes 99212 $145.00
Established Patient 15 minutes 99213 $215.00
Established Patient  25 minutes 99214 $330.00
New Patient Level IV Complexity 99204 $420.00
New Patient Level V Complexity 99205 $540.00
Psychotherapy
30 Minute Psychotherapy Add-on 90833 $90.00
45 Minute Psychotherapy Add-on 90836 $140.00
Telephone Consultation (20 minutes or less) 99442 $130.00
Telephone Consultation (30 minutes or less) 99443 $190.00
Email/Online Consultation (10-15 minutes) 99444 $55.00
Refill Out of Session that Takes Extra Time $30.00

Subset of Fees for Jasmine Teleki, PsyD

Psychotherapy CPT Code Fee
Psychotherapy 25 minutes 90832 $160.00
Psychotherapy 45 minutes 90834 $220.00
Psychotherapy 60 minutes 90837 $295.00
New Patient Initial Appointment 1.5 to 2 hours 90791 $415.00
Telephone Consultation (20 minutes or less) 98967 $85.00
Telephone Consultation (30 minutes or less) 98968 $130.00

Subset of Fees for Gina Gregory, LCSW, Alana Kivowitz, LCSW and Chris Restrivo, MFT

Psychotherapy and Care Management CPT Code Fee
Psychotherapy 25 minutes 90832 $110.00
Psychotherapy 45 minutes 90834 $160.00
Psychotherapy 60 minutes 90837 $225.00
New Patient Initial Appointment 2 hours 90791 $415.00
Telephone Consultation (20 minutes or less) 98967 $65.00
Telephone Consultation (30 minutes or less) 98968 $100.00

Additional Patient Services

Staff Assistance  $80.00 per hour

Includes requesting extensive medical records, compiling medical history, urgent refills and other assistance.

Cancellation Reminder: If you cancel with less than 7 days’ notice, you can expect to be charged, unless your appointment time is taken by another client.