Type of service Length of service Cost and payment type What you will receive
Substance abuse/use
evaluations
1 visit
2 hours
$250
Cash or money order only
A detailed report sent directly to your attorney
Bariatric or
weight loss evaluations
1 visit
90 minutes
$150
Cash or credit
A detailed report sent directly to your weight loss surgeon or care coordinator
Transgender surgery /
gender confirming surgery evaluations
1 visit
90 minutes
$150
Cash or credit
A detailed report sent directly to your surgeon or care coordinator
Pain Management evaluations 1 visit
90 minutes
$150
Cash or credit
A detailed report sent directly to your surgeon or care coordinator
Bariatric or Weight Loss Evaluations:
  • Please bring the following to your appointment:
  • • A detailed list of all medications, dosages and prescribing doctors
  • • Contact information for the requesting hospital or doctor (phone, address, fax number).
  • • Not needed if the requesting hospital is NVMC.
  • Gender Confirming Evaluations
    Please bring the following to your appointment:
  • • A detailed list of all medications, dosages and prescribing doctors
  • • Documentation of from the hospital or surgeon of information that must be included in the report
  • • Contact information for the requesting hospital or doctor (phone, address,fax number)
  • Pain Management Evaluations:
    Please bring the following to your appointment:
  • • A detailed list of all medications, dosages and prescribing doctors
  • • Contact information for the requesting hospital or doctor (phone, address, fax number)
  • • Not needed if the requesting hospital is NVMC.
  • Substance Abuse/Use Evaluations:
    Please bring the following to your appointment:
  • • A detailed list of all medications, dosages and prescribing doctors
  • • Contact information for the requesting attorney (phone, address, fax number)
  • • All relevant paperwork (court documents, charges, etc.)
  • Insurance & Pricing

    EVALUATIONS

    Christa L. Maxant, Inc. Mental Health Services

    190 Groton Road, Suite 230, Ayer, MA 01432 • Tel: 978-796-5054 • Fax: 978-796-5460

    PHONE, SKYPE*, FACETIME* OR PRIVATE-PAY SESSIONS

    Type of service Length of service Cost and payment type What you will receive
    Individual therapy or family therapy # of visits and length,of sessions will be determined after consultation,you’re your therapist
    • 15 min: $25
    • 30 min: $55
    • 45 min: $75
    • 60 min: $150
    • 90 min: $175
    • Credit only
    Number of visits,
    frequency of visits and duration of session not limited by insurance.

    *It is important to note that Skype and Facetime are not HIPAA compliant and confidentiality issues should be discussed with your therapist prior to initiating this type of treatment. It may not be appropriate for all clients.

     

    PRIVATE PAY

    Private pay is an option for a few reasons. Some clients choose to come to our office and are not covered by the insurance we accept. Others wish to keep their mental health private and separate from their health insurance. It is important to know that if you choose to use insurance for mental health services your insurance company will know certain things about you; your dates of service and your diagnosis. Insurance companies may also audit mental health records at any time. Insurance companies are not permitted to audit records of those clients who pay privately. Additionally, private pay allows you the flexibility to adjust session times to best fit your needs. Private pay clients may also opt for phone sessions, Skype* sessions or FaceTime* sessions.

     

    SUPERVISION

    Type of service Length of service Cost and payment type What you will receive
    Licensure Supervision A supervision plan will be created specifically for your needs 60 minutes: $65
    Cash, check or credit
    All required paperwork to submit to licensing board

     

    INSURANCE

    Our office offers both insurance based and private pay services. We accept the following insurances:

    • Blue Cross Blue Shield
    • Tufts Commercial Plans (not Tufts MassHealth/Network)
    • Two types of MassHealth
    • Massachusetts Behavioral Health Partnership (MBHP)
    • Commonwealth Care Alliance (OneCare)

    There are services that you may request this office to perform that are not covered by your insurance plan. These services may include report writing, consultations with other providers, IEP meeting attendance, phone calls, etc. These fees are detailed in our intake paperwork which you will be required to sign upon initiating services. Your mental health provider will ensure that any out-of-pocket expenses are discussed prior to commencement of services.

     

    If we do not currently accept your insurance your insurance may still allow you to receive services at this office through an me “out-of-network.” benefit. Simply call the behavioral health number on your insurance card and ask about your “out of network” options. What this means is that your insurance company may allow you to come to our office and pay out-of-pocket. We would provide you with a receipt and you would submit that receipt to your insurance company. Your insurance company would then reimburse you some or all of your expenses.

    If you do not have “out-of-network” benefits, and feel that you are unable to afford treatment, please contact us to discuss your needs.

     

    Payments and Fees:
    Payment is due at the beginning of each session. If you do not have your payment in full at the time of your session, you will not be able to be seen by your therapist. The office will change a $75 No-show fee for this type of missed appointment.

    Cash, check and major credit cards are excepted (Visa, MasterCard, American Express, Discover and JCB logo cards). Any returned checks will incur an additional $25 fee.

     

    No-Show Appointments and Late Cancellations:

    Your therapy time is important to us. We make every effort to make appointment times convenient and flexible for your busy schedule. We understand that sometimes appointments need to be canceled. Please make every effort to cancel or reschedule appointments as early as possible so that we may offer this time to someone else in need. Should you fail to cancel your appointment with 24-hour notice or do not show up to your appointment the office will charge your account $75. You will need to pay this amount prior to rescheduling another appointment. We thank you for your understanding.

     

    Limitations to Confidentiality

    We are required to keep our conversations and your records confidential. We are bound by both professional ethics and legal standards to do this. We may only release your records (or even the fact that you are a client) if you request, in writing, that we release your records. However, there are times when we are legally and ethically obligated to break confidentiality, including:

    • If you present a serious, imminent danger to yourself or others
    • In cases of apparent abuse or neglect of a child, an elderly person, or a disabled person
    • When a judge orders the release of information
    • If legal action is brought against us by a client and/or family
    • When necessary to collect fees owed

    In the rare event that we must break confidentiality, we will make every attempt to discuss this with you prior to any action. We will always reveal only the minimum amount of information necessary.

     

    CHRISTA L. MAXANT, INC. • 190 Groton Road, Suite 230 Ayer, MA 01432• 978-796-5054 • INFO@CHRISTAMAXANT.COM