Initial sessions $220

Follow up appointment $200

Couples/ Family therapy $220

15 min consultations Free * available for new patients at 510 552 2327 or send an email to mkelsch@middlewaypsychotherapy.com. Many clients use a Health Savings Account (HSA) and/or Flexible Spending Account (FSA) for reimbursement of accrued therapy expenses or seek Out of Network reimbursement.
The length of therapy varies a great deal based on your goals and what is bringing you to therapy. Many clients may be in therapy weekly for 12-18 weeks. Some simple cases find resolve in 4-6 sessions. The majority of clients spend between $1,000 to $5,000 on therapy depending on how much help is needed. For many people, therapy is part of their ongoing wellness plan and may be anywhere from weekly to quarterly to process ongoing mental health concerns. I am in the practice of regularly reviewing care with clients to affirm medical necessity and therapeutic gains.

If you are seeking therapy and are uninsured or will no be seeking reimbursement form your insurance company, you have the right to request a Good Faith Estimate of services as part of the No Surprises Act, which is part of the Consolidated Appropriations Act of 2021.

I am contracted with Medicare part B and supplemental plans. I am not contracted with Medi Cal or Medicare Advantage plans. For all other insurers I am an out of network provider.

 As a small business owner and social worker I had to make a choice on where to put my energy. Insurance companies create many barriers and significant increase in up paid labor, which takes my time away from providing high quality patient care. As a person with a disability who has been on Medicare, I feel a strong desire to give back to my community by accepting Medicare.

Out of network providers are licensed health care providers who have opted to not contract with insurance carriers. The benefit to you working with an out of network private practice is more stable care. For example, if you change your job and you have new insurance you would not need to look for a new therapist, in addition I own my business so turn over is low! Insurance companies recognize their in-network providers cannot accommodate the demand for therapy, and they likely do not work with enough therapists who have open availability. Per Senate Bill 221 insurance companies in California are required to have therapist available within 10 business days of a patient needing care. Colorado has similar laws.

Many insurance plans offer out of network benefits- Contact your insurance provider, it may mean a lot of savings for you. Be prepared to ask questions when you call; What are my benefits for behavioral health? , What percentage do you reimburse for routine out of network behavioral health care?, How many therapy sessions are covered in my plan? Is approval required by my primary care physician?

Please note that I do NOT fill out any forms that are created by your insurance company and do NOT correspond directly with them in any way. Whenever insurance is used for psychotherapy, the treatment must be considered “medically necessary” and will require the documentation of a diagnosis. Other personal information may also be required for reimbursement by your insurance provider and at times they may ask to be given your records.

For out of network care a super bill will be sent to you (invoice of services rendered) on the 3rd of each month. You submit this super bill to your insurance company to receive reimbursement. You can log into the client portal and download your super bills at your convenience.

People come to therapy for many reasons, grief, trauma, chronic mental illness, physical illness, relationship stress, burnout, difficulty maintaining life balance, exploring behavior patterns, exploring self- sex, sexuality, gender, interests, abilities, disabilities, neuro diversity and the list goes on. Some people come to therapy to learn new ways of processing emotions and gaining more control of behaviors that are in reaction to their emotions and thoughts. Often times people come to therapy because they have recognized a desire for something to be different and want support to find a path to change.

Therapy has been shown to be as effective as medication in reducing symptoms of anxiety and depression. It has also been sown to help improve emotional awareness, increased insight into self and patterns of behavior, improve distress tolerance, improve social engagement, communication skills, shift perspectives to past trauma.

A therapist can provide a safe space to process, coping tools, reflections on your patterns and values conflicts, highlight successes you may have over looked and assist you in finding creative solutions. Therapists can provide a neutral insight into interpersonal conflicts and familial patterns. They can also bring forth treatment modalities to foster conversation, new perspective and scaffolding for personal reflection.

Your active participation inside and outside of therapy will improve your outcome. 30% of therapy is done in session, the other 70% is done when you leave the office. Occasionally your therapist may suggest an exercise or experiment for you to try outside of the session- the intention is for you to discover things that work for you and things that don’t, allowing for deeper insights.

My services do not include medication assessment or prescribing. For some diagnosis, best practice is a combination of medication and therapy. If needing a medication evaluation, I can offer referrals.

All things in therapy are kept confidential, unless you provide written consent for information to be shared. In some cases, it’s best practice to have open communications with supports, such as psychiatrists or a family member to better support your needs, in which case I will make the recommendation as part of your treatment. If there is imminent risk of harm to you or another person(s) and it can not be prevented, or there is concern for child or elder abuse, I am legally mandated to report the information, I will discuss this with you first if it is safe to do so.

Teletherapy is doing therapy by video streaming over the internet or over the phone. Video sessions are preformed with HIPPA compliant technology to protect your privacy. Teletherapy allows you to do therapy from the comfort of your own home, office or other confidential space. When attending a session it is important that you be in the state of California or Colorado, as I am licensed in those states. Some states have agreements that allow for very brief treatment to allow for transfer of care for situations such as someone moving out of state for a crisis.

Teletherapy allows for you to save time, money and in many cases I have found it allows for better consistency of care.

Current studies have found Teletherapy to be as effective as in person sessions, though it is likely that some conditions would be better treated in person. At this time in the state of California, insurance companies cover teletherapy the same as in person sessions.

I am open Tuesday thru Thursday 10 am to 8pm and Fridays 10 am to 3pm. I check messages occasionally Saturday thru Monday.

Current patients can reach out at any time by leaving me a voice mail at 510 552- 2327 or sending me a secure message through the client portal. It is okay to text me for administrative purposes such as needing to cancel or move an appointment, it is not okay to text me with clinical needs. If you reach out to me on social media platforms I will not reply as they are not secure.

Your therapy time is reserved for you. Please cancel 24 hours before your session to avoid a full fee charge for a missed appointment. There are times where late cancellation is unavoidable and I will determine if the fee can be waived. Multiple late cancellations will result in termination of care.

If you are experiencing a life threatening emergency call 911 or go to your nearest emergency room. If you are experiencing an urgent matter and can wait to be seen; I keep a small case load and am often able to fit patients in for urgent sessions. 988 is a national hotline with trained volunteers that can also assist when having an urgent mental health need 24/.

At this time all of my sliding scale fee spots are filled. Below are some providers that offer lower cost therapy services, many of them have therapists in training that are under supervision.

Open Counseling.com https://www.opencounseling.com/

California Family Institute http://www.californiafamilyinstitute.org/counseling-center.html

The Hume Center https://www.humecenter.org/

Open Path https://openpathcollective.org/

Access Institute https://www.accessinst.org/