Fee Schedule

January 5, 2022

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 $165.00
Established Patient 15 minutes 99213 $250.00
Established Patient  25 minutes 99214 $375.00
Established Patient  40 minutes 99215 $450.00
New Patient Level IV Complexity 99204 $480.00
New Patient Level V Complexity 99205 $615.00
Psychotherapy
30 Minute Psychotherapy Add-on 90833 $105.00
45 Minute Psychotherapy Add-on 90836 $160.00
Telephone Consultation (20 minutes or less) 99442 $150.00
Telephone Consultation (30 minutes or less) 99443 $220.00
Email/Online Consultation (10-15 minutes) 99444 $70.00
Refill Out of Session that Takes Extra Time $40.00

Subset of Fees for Jasmine Teleki, PsyD

Psychotherapy CPT Code Fee
Psychotherapy 25 minutes 90832 $210.00
Psychotherapy 45 minutes 90834 $320.00
Psychotherapy 60 minutes 90837 $385.00
New Patient Initial Appointment 1.5 to 2 hours 90791 $495.00
Telephone Consultation (20 minutes or less) 98967 $100.00
Telephone Consultation (30 minutes or less) 98968 $150.00

Subset of Fees for Andrea Starn, MFT, Chris Restivo, MFT and Alana Kivowitz, LCSW

Psychotherapy and Care Management CPT Code Fee
Psychotherapy 25 minutes 90832 $135.00
Psychotherapy 45 minutes 90834 $210.00
Psychotherapy 60 minutes 90837 $270.00
New Patient Initial Appointment 2 hours 90791 $495.00
Telephone Consultation (20 minutes or less) 98967 $80.00
Telephone Consultation (30 minutes or less) 98968 $120.00

Additional Patient Services

Staff Assistance  $120.00 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.