Hours and Fees


Hours are by appointment only due to each of our therapists having their own unique schedule. Our office provides early morning, day, and evening appointments to accommodate our clients’ schedules.  We also have a few therapists that have available on Saturdays & Sundays. Upon scheduling an intake session with a clinician, our office will provide all general availability to determine if that specific therapist is a good fit for you since each clinician controls their own schedule.  It is a common practice in our office that if an ideal time opens up in a clinician’s schedule, they offer that spot to their current clients first, then offer it to new clients.  It’s recommended that clients are flexible with our therapists to ensure we can get you in sooner!

Cancellation policy

The client must cancel or reschedule their appointment 24 hours ahead of the scheduled appointment time, or the client is charged. The client’s credit card (or check) on file will be charged (cashed).  Example:  If the appointment is at 4pm on Wednesday, one would need to call at 4pm on Tuesday to avoid being charged.

Payment Details

Please see the section about using your insurance. Please read it all the way through.  It is the client’s responsibility to know their own insurance benefits and to be responsible for the amount that their insurance company does not pay due to deductibles, copay, or co-insurance.


  • 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

LPCs and LCSWs offer a sliding scale for those who are in need. Please ask about this option when scheduling your intake appointment. In order to utilize a sliding scale, clients must show documentation, there is a chart that compares the types of sessions with household income.


  • 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

For Provisional Therapists the fees are slightly lower. Every single one of our provisional therapists offers a sliding scale.  Please ask about this option when scheduling your intake appointment. In order to utilize a sliding scale, clients must show documentation.


The client’s session fee is due at the time of service. Step by Step Counseling, LLC accepts cash, check, or credit cards for session payments.  Credit cards are run through our EHR, and clients have the option to be e-mailed receipts upon request. Many of our clients choose to use their FSA (Flexible Spending Accounts) or HSA (Health Spending Accounts) to pay for counseling. Our office is equipped to accept this type of payment through our EHR. If clients want to use this option, they should discuss this with their therapist. Depending on what the client may need for their own records (Or for third-party reimbursement), a receipt (superbill) for Out of Network payments and appointment dates can be given monthly, or quarterly. New clients should speak to their therapist to discuss their preferences.

Clients can also opt to have a 3rd party pay for their counseling services.  This includes their employer, a private agency, a church, a family member, etc.  Once we have a release of information, the office can work with the 3rd party to ensure that payment is timely. Please have that 3rd party contact our office to set up billing and payment once a release of information has been completed.  This is a very common option!


Reduced Fees

Graduate Level Interns (Stepping Stones Program)   

The fee for a stepping stones session is $40 for individual, family, or marriage/couples counseling.   Many clients choose this option if they don’t have insurance, or they can’t afford to use their insurance.  Others choose this option because they are on a limited budget. Everyone qualifies and anyone can use this option for counseling.  There is no a cap or limit on the number of sessions a client can use. Clients can see an intern twice a week, once a week, once every other week, etc.   In the first session, the client and stepping stones therapist will determine the frequency of appointments.

If interested in this option specifically ask about the graduate interns and their availability. Limited slots are available, please mention this when scheduling your first appointment. 

Positive Directions

Similar to the traditional EAP, however more personalized to the company the client comes from. Client must see their employer for more information. Typically employers pay some or all costs involved. If you are a small business and would like to coordinate Positive Directions sessions for your employees or staff please contact our office and we would be more than happy to set one up for you. We offer various options for small businesses!

Safe and Sound Protocol

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)

IOP – SPARK Program for elementary aged children 

  • $200 for intake which includes an assessment, treatment plan and crisis plan 
  • Per day / Per diem rate is $200.  
  • Insurance: 
    • We can bill homestate health / Show me Healthy Kids in-network
    • Commerical insurance(Anthem, UHC, Aetna) require using out of network benefits, or single case agreements.
    • Medicaid (Healthy Blue and UHC-Community), require a single case agreements.  

Whether in-network, out of network or single case agreement, for families seeking reimbursement from their insurance companies, we can absolutely provide a letter of necessity if requested for out of network benefits or for one time case agreements. In light of the fact that we are the only IOP for elementary-aged children in our area, we understand the complexities. 

Single case agreements / One time case agreements need to be Initated by client. Family reaches out to their plan, requesting that level of support from member services.   They will do their due diligence in looking for an in-network option first, when they are unable to find one, family can request a single case agreement.  The insurance company then reaches out to the office to set that up.   Save

Managed Care/ Using your Insurance

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.

Reasons for NOT using insurance:

Some clients choose not to use their insurance for a wide range of reasons. Some popular reasons are:

  • Insurance companies REQUIRE a diagnosis in order to pay for your session.  What we find is that not everyone who comes to counseling has a diagnosis. Some are just struggling in relationships, in their jobs or working through grief.
  • The diagnosis that is given, will REMAIN on the client’s permanent health record.   This diagnosis will follow the client in school, enlisting in the military, landing federal jobs, security clearances, applying for life insurance, etc.
  • Insurance companies can REQUEST the clients’ session notes at any point in time (by using your insurance you waive confidentiality) and many clients feel uncomfortable with this.
  • Insurance companies DECIDE what type of treatment they will cover, and what type of treatment they will not.  Example: Many companies will not cover couples counseling, or will not cover specific diagnoses. Or some will only cover a particular code, even if you need a different code. Another example, some companies will not cover particular diagnoses such as adjustment disorder (grief, teenage angst, etc) 
  • Insurance companies can LIMIT the number of sessions that a client can have by age & Diagnosis
  • The provider a client wants to see is not PANELED with their insurance company, or perhaps is paneled with their insurance company but not your specific plan.
  • Insurance company copay or deductible is too high; therefore clients may opt to utilize our internship program.


What goes into my intern or therapist’s fee?

  • Rent, utilities, phone, office supplies, toys, etc
  • Insurance (property/renters insurance, professional liability, business) and taxes
  • Required CEUs, training, credentialing fees, supervision/consultation fees
  • Electronic Health Record, hippa-compliant storage
  • Billing/claim fees, Clearinghouse (required by insurance),  credit card fees, etc
  • Marketing, promoting practice
  • Collaboration, coordination of care, expected documentation
  • Take home salary

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