Your Right to a Good Faith Estimate
Under Section 2799B-6 of the Public Health Service Act (the No Surprises Act), healthcare providers are required to give clients who are uninsured, or who are not using insurance for a particular service, a Good Faith Estimate of expected charges before services are provided.
Scheduling and billing for my practice are handled by Mindful Therapy Group, which issues Good Faith Estimates on my behalf. When you schedule, you will be asked whether you have insurance and whether you plan to use it. If you are uninsured or choose to pay out of pocket, you will receive a written Good Faith Estimate automatically: within one business day of scheduling if your appointment is at least three business days away, or within three business days of scheduling if it is at least ten business days away.
You can also request a Good Faith Estimate at any time before scheduling, and one will be provided within three business days. To request one, contact Mindful Therapy Group at (425) 640-7009 or reach out through the contact form.
Provider Information
Provider: Jackson Michener, LMHCA
Practice: Jackson Michener Psychotherapy, PLLC
Location: Seattle, WA
License: Licensed Mental Health Counseling Associate, Washington State (MHCA.MC.61691478)
NPI: 1104763481
Group Practice: Mindful Therapy Group (scheduling, billing & Good Faith Estimates)
Services Offered
Jackson Michener Psychotherapy currently offers the following clinical services. All sessions are 53 minutes in length.
| Service | CPT Code | Session Length | Standard Fee |
|---|---|---|---|
| Individual Therapy | 90837 | 53 minutes | $150 |
| Couples Therapy | 90847 | 53 minutes | $185 |
| Family Therapy | 90847 | 53 minutes | $200 |
A sliding scale is available for private-pay (self-pay) clients. Individual sessions can be reduced to as low as $120 based on financial need. Please inquire directly.
Accepted Insurance Plans
Jackson Michener is currently credentialed through Mindful Therapy Group to accept the following insurance plans in Washington State. Coverage varies by plan and individual benefits. Please contact your insurance provider to confirm your mental health benefits before your first appointment.
- Aetna
- Cigna
- Cigna EAP
- Kaiser Permanente
- Kaiser Permanente Northwest
- Premera Blue Cross
- Regence
- United Healthcare
- United Healthcare EAP
If you are using insurance, your actual out-of-pocket cost will depend on your specific plan, deductible, copay, and coinsurance. The fees listed above reflect the standard self-pay rate and may differ from what you owe after insurance applies.
Estimated Cost of Treatment
The total cost of your care will depend on the duration of services. I recommend weekly sessions as the standard of care for most clients, so the estimates below assume a weekly cadence at the standard self-pay rate. These are estimates only — your actual course of treatment will be determined collaboratively.
- Weekly individual therapy for 12 weeks (12 sessions): approximately $1,800
- Weekly individual therapy for 6 months (26 sessions): approximately $3,900
- Weekly couples therapy for 12 weeks (12 sessions): approximately $2,220
- Weekly family therapy for 12 weeks (12 sessions): approximately $2,400
At the lowest sliding-scale rate of $120, weekly individual therapy for 12 weeks would be approximately $1,440.
Late Cancellation and No-Show Fee
The estimates above do not include missed appointment fees. A fee of $150 is charged for any late cancellation (less than 48 hours' notice) or no-show, regardless of the reason. Arriving more than 10 minutes late without notice is treated as a no-show. This fee is not covered by insurance and is charged to the card on file.
Where state law prohibits this fee, such as for Washington Apple Health (Medicaid) clients, it will not be charged.
Self-Pay Clients
If you are not using insurance, you will be billed at the standard self-pay rates listed above. If you have out-of-network benefits, you may be able to submit a superbill (a detailed receipt) to your insurance provider for potential partial reimbursement. Please contact your insurer to understand your out-of-network mental health benefits before beginning services.
Your Rights Under the No Surprises Act
If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-985-3059.
A Good Faith Estimate is not a contract and does not obligate you to obtain services. It does not include unknown or unanticipated costs that may arise during treatment. You are entitled to a written Good Faith Estimate specific to your situation before beginning services.
Questions
If you have questions about fees, billing, insurance, or your rights as a client, please reach out through the contact form or email [email protected] directly. You will receive a response within two business days. For scheduling or billing questions, you can also contact Mindful Therapy Group directly at (425) 640-7009.