Quick Answer: Confluence Psychiatry is a self-pay practice. A comprehensive evaluation is $320, follow-up visits are $160 for 25 minutes or $280 for 55 minutes with therapy, ketamine treatment starts at $360 including the first session, and TMS is charged as one all-inclusive rate from $2,800 to $5,500 depending on the schedule. We aren't currently in network with insurance. Every fee is discussed with you before you book.

Most psychiatry websites won't tell you what anything costs. You call, you leave a message, and you find out the price after you've already invested time in the process. We'd rather put the numbers in front of you now, along with an honest explanation of what self-pay means and when it isn't the right choice.

What "Self-Pay" Actually Means

Self-pay means you pay the practice directly rather than the practice billing your insurance company.

We aren't in network with insurance plans at present, though we intend to be. Until then, every fee on this page is what you pay, and there's no separate bill arriving weeks later from someone you've never heard of.

There's a trade-off here, and it's worth being straight about it. Self-pay costs more out of pocket than an in-network copay. What you get in exchange is appointment length set by what your care needs rather than by billing rules, continuity with the same psychiatrist rather than whoever is available, and no prior authorization deciding what treatment you can have.

Psychiatry Appointment Fees

• Comprehensive psychiatric evaluation (about an hour): $320

• Follow-up visit (25 minutes): $160

• Follow-up visit with therapy (55 minutes): $280

The first appointment is always the comprehensive evaluation. It covers your symptoms and history, previous treatments and how they went, medical background, and where things stand now. Everything that follows is built on it.

After that, how often you come in depends on what you're being treated for and how stable things are. Someone starting a new medication will be seen more often at first. Someone stable on a long-term plan may need only occasional visits.

Ketamine Treatment Costs

• Initial comprehensive evaluation, including your first ketamine treatment: $360

• Follow-up ketamine treatments: $250 each

Insurance does not cover ketamine treatment. That's true across the board, not a quirk of this practice.

Spravato (esketamine) is also available here. Coverage for Spravato works differently from ketamine, so ask us directly about it when you call rather than assuming either way.

TMS Pricing

TMS is charged as a single all-inclusive rate. There are no per-session fees added later, and follow-up visits and touch-up sessions are already in the price.

• Standard TMS: $3,800. Includes the evaluation, 36 sessions delivered daily over six to eight weeks, follow-up visits, and free touch-up sessions within six months if you need them.

• Accelerated TMS, five days: $5,500. Includes the evaluation, 50 sessions during the treatment week, follow-up visits, and free touch-up sessions within six months.

• Accelerated TMS, two days: $2,800. Includes the evaluation, 20 sessions over two days, a follow-up visit, and free touch-up sessions within six months.

The touch-up sessions matter more than they might appear. If symptoms return within six months of finishing a course, you're covered rather than facing a new bill.s

Medical-Legal Work

Court-ordered evaluations, expert witness testimony, and evaluations required by a regulatory body are priced individually. These fall outside standard clinical care, and the fee depends on what's involved. Contact us to discuss.

Insurance, HSA, and FSA

Insurance. We aren't in network yet. We do plan to accept private insurance in future, and we'll update our pricing page when that changes.

Out-of-network benefits. Some plans reimburse part of what you pay for out-of-network care. Whether yours does, and what paperwork it needs, is a question for your insurer. Ask us what documentation we can provide.

HSA and FSA. Psychiatric care is generally an eligible expense for health savings and flexible spending accounts. Check with your plan administrator, since rules vary between plans.

Is Self-Pay Right for You?

Self-pay works well if you want longer appointments, continuity with one psychiatrist, and treatment decisions made between you and your doctor without an insurer in the middle. It also suits people who've found that in-network waiting lists mean months before a first appointment.

It's the wrong choice if the cost would genuinely strain your finances. Care you can't sustain isn't care. If that's the position you're in, say so when you call. We'd rather point you toward something workable than start a course of treatment you can't continue.

Our physicians are available for a phone consultation before you schedule, to talk through which option makes sense for your situation and your budget.

Learn More : Pricing