Fees + Insurance

At Thriving Wellness Center, we believe that financial expectations should be clear before services begin. We are a private-pay, out-of-network practice. This means clients are responsible for payment directly to Thriving Wellness Center, and we do not bill commercial insurance companies on your behalf.

Some clients may be eligible for reimbursement through out-of-network benefits, depending on their individual insurance plan. We provide superbills that contain the information generally needed to submit a claim to your insurance company.

How much does an Autism or ADHD evaluation cost?

Virtual Evaluations (Telehealth)

• Single Condition (Autism or ADHD): $875

• Combined Autism & ADHD Evaluation: $1050

In-Person Evaluations conducted in Ridgewood, New Jersey

• Single Condition (Autism or ADHD): $1250

• Combined Autism & ADHD Evaluation: $1450

Optional Add-Ons

• Comprehensive Diagnostic Report (15+ pages): $750
  Includes mental health history, detailed interpretation of assessment results, diagnosis (if applicable), and personalized recommendations for therapy, accommodations, or next steps.

• Accommodation Letter (2 pages): $300
  Provides a formal request for academic or workplace accommodations, tailored to your needs and based on your evaluation results. This can be added after the evaluation.

• Follow-Up Results Session (45 minutes): $325
  Meet one-on-one with your evaluator to review your results in depth, ask questions, and receive tailored guidance and support.We use the same evaluation process for both virtual and in-person appointments.

If you receive a diagnosis, you will be provided with an official, signed diagnosis letter. This letter includes your identifying information, diagnosis date, diagnostic criteria, evaluation results, severity level (if applicable), assessment tools used, and healthcare provider credentials. You will also receive a document with resources to support your understanding of the diagnosis and guide next steps.

In addition to the diagnosis letter, we offer a comprehensive 15-page diagnostic report for those who would like a more in-depth summary. This report includes your mental health history, current challenges across work, school, and home environments, your diagnosis (if applicable), and personalized, evidence-based recommendations. It can be shared with other healthcare providers or used to access medication, therapy, educational support, or workplace accommodations.

Learn more about the the differences between a comprehensive diagnostic report and diagnosis letter.

We also offer an optional results session for clients who would like to review their findings in greater detail. This 45-minute session provides an opportunity to ask questions, process your diagnosis, and receive tailored guidance for moving forward.

These optional services are designed to provide deeper insight, support, and clarity following your ADHD or Autism evaluation.

The evaluation fee includes the clinical assessment process and diagnostic feedback appropriate to the evaluation. An evaluation does not guarantee a particular diagnosis or outcome. Diagnostic conclusions are based on the clinician's professional assessment of the available information and evaluation results.

Click here to schedule your evaluation.

How much are sessions?

In an effort to provide you with the most up-to-date information regarding fees, please contact us at the Thriving Wellness Center.

Therapy is an investment in yourself — one that supports you in creating a more fulfilling and satisfying life. Our fees reflect the experience, education, and dedicated time that our therapists bring to every session.

Do you take insurance?

We are an out-of-network practice, which means we are not contracted with insurance companies and do not bill insurance directly. However, many insurance plans include out-of-network benefits. This means your insurance company may reimburse you for a portion of each session fee after you’ve paid. Reimbursement is determined solely by your insurance company and your individual plan.

How the process works:

1. You pay for your session at the time of service. We accept all major credit and debit cards (American Express, Discover, Mastercard, Visa) and HSA/FSA cards.

2. We provide a superbill (paid invoice with appropriate medical billing codes) for you to submit to insurance for reimbursement.

3. You submit superbill to your insurance company.

4. If your plan includes out-of-network benefits, your insurance sends you reimbursement for a percentage of the fee.

Thriving Wellness Center does not guarantee insurance reimbursement, coverage, or the amount your insurance company will pay. We also do not contact insurance companies on behalf of clients to determine benefits, obtain reimbursement, or resolve claims.

Before scheduling, we recommend asking your insurance company:

• Do I have out-of-network mental health benefits?

• Does my plan cover out-of-network telehealth services?

• What is my out-of-network deductible?

• Has my deductible been met?

• What percentage of the allowed amount is reimbursed after the deductible?

• Is there a separate out-of-network deductible or out-of-pocket maximum?

• Are there annual session or service limits?

• Does my plan require prior authorization?

• What documentation is required for reimbursement?

• How are diagnostic evaluations reimbursed?

• Does my plan reimburse the specific type of service I am seeking?

If possible, request a written explanation of your benefits.

Please do not rely solely on information provided by an insurance representative regarding coverage. Your insurance plan ultimately determines whether and how a claim is reimbursed.

Medicare & Medicare Advantage

Medicare

Medicare participation is separate from commercial insurance network status.

Being an out-of-network provider for a commercial insurance plan does not mean that Medicare will reimburse services. Thriving Wellness Center clinicians may have opted out of Medicare. When a clinician has validly opted out of Medicare, Medicare generally does not reimburse Medicare-covered services provided under a Medicare private contract.

If you have Medicare, please contact Thriving Wellness Center before scheduling so we can confirm the applicable clinician's Medicare participation status and explain any private-pay requirements.

Medicare Advantage

Medicare Advantage plans have their own network, authorization, and reimbursement requirements. A provider being described as "out-of-network" does not necessarily mean that a Medicare Advantage plan will reimburse the service.

If you have Medicare Advantage, please contact your plan directly to determine:

• Whether the clinician is participating or non-participating with your specific plan

• Whether out-of-network behavioral health benefits are available

• Whether prior authorization is required

• Whether the service is covered

• Whether the plan will reimburse services provided by a clinician who has opted out of Medicare

• What documentation is required

Thriving Wellness Center does not guarantee Medicare Advantage reimbursement. A superbill does not create an entitlement to reimbursement.

Medicare Private Contracts

When required, a separate Medicare private contract may need to be completed before services begin. The private contract explains that services are being provided on a private-pay basis and addresses the applicable Medicare requirements. Clients with Medicare who do not wish to enter into a private-pay arrangement may choose to seek care from a Medicare-enrolled provider. If you have questions about Medicare requirements or your financial responsibility, please contact us before scheduling services.

Medicaid & NJ FamilyCare

Thriving Wellness Center clinicians do not participate as Medicaid or NJ FamilyCare providers. We do not submit claims to Medicaid or NJ FamilyCare on behalf of clients.

When permitted by applicable law and program requirements, clients may choose to receive services on a private-pay basis and remain responsible for the full private fee.

Medicaid or NJ FamilyCare generally will not reimburse services provided under a private-pay arrangement with a non-participating provider. A superbill or receipt does not guarantee or create Medicaid reimbursement eligibility.

If you have Medicaid, NJ FamilyCare, or a Medicaid managed-care plan, please contact your plan before scheduling to understand your available options.

Commercial insurance, Medicare, Medicare Advantage, and Medicaid are different programs with different rules. For this reason, "out-of-network" should not be interpreted to mean that every insurance plan will reimburse services.

Cancellation & No-Show Policy

We require 48 hours' notice to cancel or reschedule an appointment. Appointments canceled or rescheduled with less than 48 hours' notice, as well as missed appointments, will charged the full session fee.

For diagnostic evaluations, cancellations or missed appointments with less than 48 hours' notice may be subject to a $75 cancellation/no-show fee, even if the appointment is subsequently rescheduled, when applicable to the scheduled evaluation.

What types of payment do you accept?

We use an automated secure third-party system to generate paid invoices and to automatically charge your credit card on file. We accept all major credit and debit cards (American Express, Discover, Mastercard, Visa) and HSA/FSA cards. We also accept Venmo and Zelle.

Complete Practice Policies & Informed Consent

The information on this page provides an overview of our fees, payment policies, insurance practices, and selected financial disclosures.

Before beginning services, clients are provided with our complete Practice Policies & Informed Consent, which contains additional information regarding:

• Sessions and attendance

• Cancellation and rescheduling

• Professional fees

• Billing and collections

• Insurance

• Medicare and Medicare Advantage

• Medicaid and NJ FamilyCare

• Telehealth

• Electronic communication

• Confidentiality

• Minors

• Health information and records

• Legal proceedings

• Termination of services

• Emergencies and crisis services

• Client responsibilities

• Changes to policies and fees

Clients are responsible for reviewing the complete Practice Policies & Informed Consent before beginning services.

Questions About Fees or Insurance?

If you are unsure whether a particular service is appropriate for you, or if you have questions about fees, insurance, Medicare, Medicare Advantage, Medicaid, or payment requirements, please contact us before scheduling your first appointment. We can provide information about our services and applicable fees. However, your insurance company is responsible for determining your coverage and reimbursement.

Contact Thriving Wellness Center

info@thrivingwellnesscenter.com
(201) 632-3050

New Jersey
75 N. Maple Ave.
Ridgewood, NJ 07450

New York
220 E. 54th St.
New York, NY 10022