Our sessions are by appointment only, because each therapist at our practice maintains their own individualized schedule. This allows clinicians to work in ways that support their best clinical work and their long-term availability for families.

What this means for you:

• We offer early morning, daytime, and evening appointments across the week

• A limited number of clinicians also offer Saturday and Sunday sessions

• Availability varies by therapist, and office location

When you schedule an intake, our team will walk you through a clinician’s current general availability so you can decide whether that schedule is a good fit for your family. Because therapists manage their own calendars, availability can shift as caseloads change.

A few important things to know:

• When a preferred time opens up, therapists typically offer that spot to current clients first to support consistency of care

• Openings are then offered to new clients as they become available

• Families who can offer some flexibility with days or times are often able to start sooner

Our goal is to help you find not just an opening, but the right opening with the right clinician. Client flexibility helps us move more quickly, but fit always comes first.

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We strongly encourage all clients to carefully review the Using Your Insurance section in full before beginning services.

While our team is happy to help explain general processes, insurance benefits are determined by your individual plan, not by the provider. For this reason:

• Clients are responsible for understanding their own insurance coverage

• Clients are responsible for any portion not covered by insurance, including deductibles, copays, and co-insurance

• Charges not paid by the insurance company remain the client’s responsibility

Being informed about your benefits helps prevent surprises and allows therapy to stay focused on care, not billing questions.

For LPC, LMFT and LCSWs

• 90791 (Intake) $150
• 90832 $75 *** 16-25 minute session
• 90834 $150  *** the traditional 45-50min session
• 90837 $188  *** the traditional 60-minute session
• 90847 $150  Family with the client.  Ask about couples therapy, some companies will not cover couples therapy
• 90846 $150 Family w/out client, can also be used as parent sessions
• 90785 $15 – interactive complexity, used for many play therapy sessions

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Some of our Clinicians offer a limited number of sliding scale appointments for individuals and families who may need financial flexibility.   Sessions with Provisional Therapists are offered at a lower fee, making them a more accessible option for many individuals and families.

What to know:

• All provisional therapists offer sliding scale pricing

• Sliding scale options must be discussed when scheduling your intake

• Documentation is required to determine eligibility

Provisional therapists are closely supervised and provide high-quality, evidence-informed care while increasing access to services for our community.

A few important things to know:

• This option must be discussed at the time of scheduling your intake

• Documentation is required to determine eligibility

• Fees are set using a standardized chart that considers household income and session type

If cost is a concern, please let our scheduling team know early so we can explore appropriate options with you. Our goal is to balance accessibility with sustainable care.

For PLPC, PLMFT and LMSWs

• 90791 (Intake) $95/session
• 90832  $48/session
• 90834  $95/session
• 90837 $120/session
• 90847 (50 minutes, family session) $95/session
• 90846 (50 Minutes, Family w/out client, parent sessions) $95/session
• 90785 – interactive complexity $15

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Clients may also choose to have a third party cover the cost of counseling services. This may include:

• An employer

• A private agency

• A church or community organization

• A family member

Once a Release of Information is completed, our office can coordinate directly with the third party to arrange billing and ensure timely payment. The third party should contact our office to set up payment after the release is in place.

This is a common and well-supported option, and our team is happy to assist with coordination.

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Graduate Level Interns (Stepping Stones Program)   

Our Stepping Stones Program offers counseling with graduate-level interns at a reduced rate, making therapy more accessible without limiting care.

• Sessions are $40 for individual, family, or couples counseling

• This option is often chosen by clients without insurance, those with high deductibles, or families working within a tight budget

• Everyone qualifies. There are no income requirements or restrictions

• There is no cap or limit on the number of sessions

Clients may attend sessions:

• Twice per week

• Weekly

• Every other week

• Or at another rhythm that fits their needs

During the first session, you and your Stepping Stones therapist will collaboratively determine the frequency that best supports your goals.

Graduate-level interns are closely supervised and supported by our licensed clinical team, allowing them to provide thoughtful, evidence-informed care while increasing access to services in our community.

If you are interested in this option, please specifically ask about graduate interns and current availability when scheduling your intake.

Spots are limited, so mentioning this preference early is important.

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This intervention is not covered by insurance, since there is no CPT code to associate it with. SSP is an out-of-pocket expense. In regards to fees, each phase has a different cost associated.  SSP has 3 phases, clients can choose to do 1, 2, or all three phases.  This can be determined at your SSP intake session.

SSP Individual:

• SSP Intake – $150
• SSP Connect
  • Minimal support – $75/month (Unlimited access to SSP Connect protocol)
  • With monthly session included – $130/month (unlimited access to SSP Connect protocol)
• SSP Core – $350 for 5 hours (without SSP provider present)
• SSP Core – $650 for 5 hours
  • Option 1: $130 for a listening session with an SSP provider (1 hour of listening at a time, could be longer with a provider, 5 times)  Option 2: $65 for a listening session with an SSP provider (1/2 hour of listening at a time, could be longer time with a provider 10 times)

• • SSP Balance
    • Minimal support – $75/month (Unlimited access to SSP Balance protocol)
    • With monthly session included – $130/month (unlimited access to SSP Balance protocol)SSP Intake – $150
• SSP Connect
  • Minimal support – $75/month (Unlimited access to SSP Connect protocol)
  • With monthly session included – $130/month (unlimited access to SSP Connect protocol)

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If choosing to use your insurance, please contact the insurance company to find out if we are a provider on your specific plan, with in your specific insurance company.

Questions to ask your insurance company in regards to your benefits:

• My therapist is located and licensed in Missouri. Their name is __________. Are they paneled on my specific mental health plan?  (Clients will need to give them the provider’s name, NOT the counseling practice itself).  While our office as a whole tries to cover many insurance companies – not all clinicians are on all plans.
• Do I have in-network mental health benefits?
  • What are they?
  • Are there mental health diagnoses that are not reimbursable?
  • How do I get authorization?
  • How many sessions will I be approved for? How many are covered per week, per year?
  • What is my lifetime maximum for mental health benefits?
  • Does my insurance plan cover telehealth or virtual sessions?
  • Do you cover the following medical billing codes:
    • 90791 (Intake or Assessment)
    • 90832 (16-30 minute)
    • 90834 (38-45 minutes)
    • 90837 (53+ minutes)
    • 90847 (50 Minutes, Family with the client) * Ask about couples therapy, some companies will not cover couples therapy
    • 90846 (50 Minutes, Family w/out client, parent sessions)
    • +90833 – for 30+ minutes added to the above 90837 code.
    • 90785 – interactive complexity
  • What is my mental health deductible?
    • What is the coverage per session before the deductible is met?
    • What is the coverage per session after the deductible is met?
• Do I have Out of Network mental health benefits?
  • What are they?
    • What do I need to do to obtain reimbursement?
    • How long does it take to obtain reimbursement?
  • What type of coverage do I have?
    • Percent of what I pay my clinician? Example: 85%
    • A set amount? Example: $62.50 no matter what I pay my clinician
  • What is the coverage per session?
    • Before Deductible is met
    • After the Deductible is met
• What is the payment schedule, and how long does it take for insurance to process and reimburse?
• What is my annual deductible?
  • What is my deductible balance?
  • Do I have a general medical deductible or do I have a separate one for mental health?

At Step by Step Counseling, LLC, it is the client’s duty to call and check their benefits before the first session. If a client has not done so, they will be responsible for the full fee at the first session.   At times, clients might have a 3rd party help pay for co-insurance, co-pay, or high deductible.  While this may be possible, this must be arranged in advance and can include:  A private agency, their place of worship, etc.

If a client chooses to use their insurance and the therapist is not paneled with that specific plan, the client’s therapist will expect full payment up front and will provide the client with a receipt or superbill (Monthly or Quarterly)  for the client to submit to their insurance company on their own. The client is responsible for seeking reimbursement from the insurance company. Our clients are very successful in obtaining this reimbursement.

Using insurance can be helpful for many people. That said, a significant number of clients intentionally choose private pay because it offers more flexibility, privacy, and control over their care.

Common reasons include:

• A diagnosis is required for insurance billing
  Insurance companies only reimburse sessions tied to a mental health diagnosis. Many people seek counseling for life stress, relationship challenges, parenting concerns, work burnout, or grief. These experiences may not require or benefit from a formal diagnosis.

• Diagnoses become part of a permanent medical record
  Once a diagnosis is submitted to insurance, it becomes part of the client’s health history. For some individuals, this may impact future situations such as school records, military enlistment, federal employment, security clearances, or life insurance applications.

• Reduced privacy when using insurance
  Insurance companies have the legal right to request clinical documentation to justify payment. By using insurance, clients consent to this review, which can feel uncomfortable for those who value a higher level of confidentiality.

• Insurance dictates treatment options
  Insurance providers determine what services they will and will not cover. Some plans do not cover couples counseling, limit coverage to certain diagnoses, restrict treatment codes, or deny coverage for concerns such as adjustment-related stress or grief.

• Session limits based on diagnosis or age
  Many insurance plans cap the number of sessions allowed, regardless of clinical need. This can interrupt care before meaningful progress is made.

• Preferred provider limitations
  The therapist you want to work with may not be paneled with your specific insurance plan, or may be paneled with the company but excluded from your individual plan.

• High deductibles or copays
  For some families, insurance costs are higher than expected. In these cases, clients may choose private pay or utilize our Stepping Stones intern program as a more affordable option.

Choosing whether or not to use insurance is a personal decision. Our role is to provide transparent information so you can select the option that best aligns with your needs, values, and circumstances.

A therapy session fee reflects far more than the time spent in the room. It supports the full infrastructure required to provide ethical, safe, and high-quality care.

Your fee helps cover:

• Office space and operations
  Rent, utilities, phones, office supplies, and therapeutic materials, including toys and play-based resources

• Insurance and taxes
  Professional liability coverage, property and business insurance, and required taxes

• Training and professional development
  Ongoing education, required CEUs, specialized trainings, credentialing costs, and clinical supervision or consultation

• Secure technology and records
  Electronic Health Record systems, HIPAA-compliant data storage, and secure communication platforms

• Billing and payment processing
  Insurance claims management, clearinghouse fees required by insurers, and credit card processing fees

• Care coordination and documentation
  Time spent on treatment planning, collaboration with schools, physicians, and other providers, and thorough clinical documentation

• Practice sustainability
  Marketing, outreach, administrative support, and a sustainable take-home salary for clinicians

These elements ensure that care is ethical, confidential, well-supported, and sustainable for both clients and clinicians.