Payment Structure

Core Essentials for Counseling & Wellness accepts private pay and select insurance plans for eligible clinical services.

Participating Insurance Plans

We currently participate with:

• Aetna
• Blue Cross Blue Shield of North Carolina (BCBSNC)
• NC Medicaid, including participating Medicaid health plans
• UnitedHealthcare
• State Health Plan

Insurance coverage varies by plan, provider, service, and individual benefits. Participation with an insurance company does not guarantee that a particular service will be covered. Clients are encouraged to verify their behavioral health benefits, deductibles, copayments, coinsurance, and other applicable costs with their insurance plan.

Private Pay & Out-of-Network Services

Private-pay services remain available for clients who prefer not to use insurance or for services that are not eligible for insurance reimbursement.

When appropriate, superbills may be provided for eligible out-of-network clinical services. Reimbursement is determined by the client's insurance plan and is not guaranteed by Core Essentials.

Services Not Billed to Insurance

Certain services are private pay and are not billed to health insurance, including:

• Coaching
• Church and organizational consulting
• Clinician consulting
• Educational/IEP/504 consultation and meeting support
• Other non-clinical consulting services

Therapy Fees

*Couples sessions are billed as family therapy.

Psychological Evaluation Fees

Psychological evaluations are billed using time-based CPT codes. Total cost varies depending on referral questions and clinical complexity.

Important:

• Evaluations require multiple clinical hours beyond direct client contact.

• Sliding scale payment does not apply to psychological evaluations.

Case Management

Case management services, when appropriate and clinically indicated, are billed separately based on time and service complexity. Fees are discussed prior to initiation.

Group Therapy

Group therapy is offered by clinicians across licensure levels. Fees typically range from $65–$85 per session, depending on group structure and duration.

Crisis & After-Hours Services

Crisis or after-hours sessions, when available, are billed at: $300 per 50-minute session

Availability is limited and determined based on clinical appropriateness.

Sliding Scale Policy

Sliding-scale fees may be available in limited circumstances for private-pay therapy services.

Sliding scale:

• Applies to therapy services only

• Requires financial documentation, including proof of income

• Is determined on a case-by-case basis

• Is reviewed every 6–12 months

Sliding scale does not apply to:

• Psychological evaluations

• Crisis services

• Case management

• Consulting or coaching