Clients are offered a 15-minute consultation to determine best fit between client and therapist. Consultations can be scheduled by using the link: https://pivotalbreakthrough.clientsecure.me/ and selecting ‘New Client.’ If a client is unable to attend their appointment, we ask that they cancel 24 hours in advance.
Individual therapy is available online via telehealth or in the Raleigh, NC office. Sessions last 45-60 minutes, and it is recommended that you start by meeting once a week to build momentum and optimize progress toward your goals. Initial therapy sessions are $200, 45-minute sessions are $140 and 60-minute sessions are $175.
Pivotal Breakthrough Counseling Services accepts many private insurances (Aetna, Blue Cross and Blue Shield, Evernorth (formerly known as Cigna), Oscar, Oxford, and United Healthcare), however many mental health benefits vary from plan to plan. It is your responsibility to know and confirm what your insurance benefits are, whether you are using in-network or out-of-network benefits, and any limitations to your coverage. Claims are submitted to your insurance; however, if a claim is denied or rejected by your insurance company, the client is aware of the responsibility to pay the private or self-pay rate for services rendered through Pivotal Breakthrough Counseling Services, PLLC.
**For Blue Cross Blue Shield, we accept all PPO plans, including Blue Advantage, Blue Select, Blue Care, Classic Blue, Blue Options, NC State Health Plan, Blue Federal, and Out of State BCBS PPO plans. Our practice is not in-network with: BCBS Blue Value, Blue Local, Blue Home, United, Tricare, Medicare and Medicaid.**
Remember, If using health insurance, insurance companies often require that you receive a mental health diagnosis in order to access benefits. This mental health diagnosis becomes a part of your permanent medical record. We will inform and discuss with you any relevant diagnosis. Please consider this information when determining whether private pay or filing with your insurance is the desired option for you.
We recommend asking your insurance provider these questions about your benefits:
Does my health insurance plan include mental health benefits?
Do I have a deductible? If so, what is it, and have I met it yet?
Does my plan limit how many sessions I can have per calendar year? If so, what is the limit?
Do I need pre-authorization from my primary care physician for therapy to be covered?
What are the reimbursement rates for CPT codes 90791 (Diagnostic Evaluation), 90834 (Individual Therapy), 90847 (Family Therapy), and 90846 (Family Session Without Identified Client) when these services are provided by a licensed master’s level therapist, such as LCMHC(A), LCSW, or LMFT.
*Please verify your insurance coverage prior to your initial visit. If at any time your insurance coverage changes, please let us know as soon as possible in order to avoid billing discrepancies. We are happy to help!
Pivotal Breakthrough Counseling Services accepts major credit cards as forms of payment for those who would like to utilize private-pay options. Payment is due at the time of each session and your card will be kept on file for easy payment acceptance.
If you are unable to attend your session, please ensure to cancel within 24-hour notice. All sessions canceled in less than 24 hours will incur a missed/late cancellation fee of $105. You may cancel by phone, email, or by utilizing the client portal link: https://pivotalbreakthrough.clientsecure.me/. Card information is required at the time of scheduling to cover any missed/late cancellation fee.
(Please note we CANNOT bill insurance for a missed appointment, so the responsibility of payment is on the client.)