Billing policies and Frequently Asked Questions

Understanding your Good Faith Estimate (GFE)

Under the No Surprises Act, health care providers are required to provide clients with an estimate of expected charges for healthcare services, including psychotherapy, if they do not have health insurance or do not plan to use their health insurance for these services. This is to protect you from financial strain due to unexpected medical bills. You have a right to receive a Good Faith Estimate (GFE) for the total expected costs of any non-emergency healthcare services. You can ask for this GFE before you schedule a service or at any time during your treatment.

If your charges exceed the amount listed on your GFE for the stated time period by more than $400, you can dispute the bill. Keep your GFE in your records in case you need to make a dispute in the future. For more information about your right to a Good Faith Estimate or disputing a bill, visit: www.cms.gov/nosurprises.

Mixed Metaphor Therapy Fees & Sliding Scale

Effective January 1st, 2026

These services are offered on a sliding scale based on your relative financial standing. In an effort to reflect disparity in economic condition and access to wealth, the following payment system is designed for those with more wealth to help cover the costs of those with less access to wealth and resources. I trust your discernment of your current financial situation and how you fit into the global economic context.

As you decide what amount to pay, please consider your present-day financial situation governed by income, but also the following factors:

• historical discrimination faced by your peoples;
• your access to income and financial wealth, both current and anticipated (retirement,
  savings, investments, expectation of an inheritance; how easily you could earn more
  income compared to other people in your community, country, and world);
• people counting on your financial livelihood including dependents and community
  members;
• the socioeconomic conditions of your locale (relative to other places in your country and in
  the world);
• your relationship to food & resource scarcity.

Rates for 50-minute Individual, Couples, and Family Therapy
Sessions*

Solidarity Rate	This rate is for you if you have ample financial resources, due to personal earnings and/or access to inter-generational wealth. Paying this rate extends support to members without these privileges and acknowledges the value of building a diverse and more equitable community.	$175
True Value Rate	This rate is for you if you have access to financial security and do not traditionally qualify for sliding scale fee reductions. Paying this rate recognizes the actual cost to offer these services and values the time, labor, and resources of the clinician.	$160
Community Care Rate	This rate is for you if you can typically afford to meet your basic needs, but with minimal expendable income. Paying this rate acknowledges the disparity of resources afforded to folks based on the impact of oppression including racism, ableism, and classism.	$145
Reparations Rate	This rate is offered in acknowledgment of the stolen indigenous land and legacies of anti-blackness that continue to harm members of our community. We offer this rate to honor the ongoing inequity, harm, and barriers to access support and care.	$125 or below

Sessions can be lengthened in 30-minute increments with additional pro-rated fees for the added time. The following services and items are free of charge:

• Initial phone consultation (15-20 minutes)
• Document review, written reports, & letters
• Phone consultation with client (up to 30 minutes)
• Phone consultation with collaborators (up to 30 minutes)

Late cancellation

There is no charge for late cancellation of appointments. No-shows are charged the full fee for the appointment at the end of an unattended appointment. Compensation for the time and labor for services above are included in weekly appointment fees. Frequent and lengthy phone consultation and document review or preparation may require discussion about additional compensation for time and labor.

*The payment structure is inspired by and borrowed from the model of the Kintsugi Therapist Collective
and Bayo Akomolafe’s Class We Will Dance With Mountains: Into the Cracks and Skin and Spine with Joanna Hedva at Corporeal Writing.