ServiceOptions

Discounted Services

Four County Mental Health Center, in its role as a Community Mental Health Center and working toward Certified Community Behavioral Health Clinic status, provides a full range of behavioral health services to our communities, including therapy, medication management, mental health emergency treatment and specialty services.

Discounts of 10% – 90% are available for most services, and are based on the client’s household size and income and insurance arrangement.

We participate in third-party billing, accept most insurance plans, and also expect patient responsibility payments at the time of service.

Contact us for more information and for a detailed listing of services and associated charges – we are here to help.

A Word About Discounts and How to Calculate Them

  • Our catchment area is the counties where we are designated as the mental health provider for the residents of that county. Any county mill support we receive is specifically reserved to help provide lower-cost services for residents of those counties.
  • We are the designated agent for Chautauqua, Cowley, Elk, Montgomery, and Wilson counties.

How to Use the Sliding Fee Scale:

  • Find your Household size along the top row
  • Follow that column down to your Household Income
  • The blue highlight boxes on the right indicate the level of your patient payment responsibility, depending on the programs and services you are receiving
  • Fees are valid for one year, and expiration dates driven by last name of the patient

Sliding Fee Scale

2020 sliding fee scale FC orientation rev 2021 for website (3)
 

Special Cases in Determining Fees:

  • Insured clients above 200% of FPL do not qualify for Sliding Fee Scale except for CBS and CSS-type services.
  • For single parent families with children, add one dependent before setting fee.
  • Out of catchment clients (those not residing in Chautauqua, Cowley, Elk, Montgomery, or Wilson) do not qualify for Sliding Fee Scale
  • For families / households with more than 6 persons, add $5,637 to income levels above for each additional person
  • Not all services are eligible for fee discounts. See Four County associate for details
  • Patient responsibility for cost of services delivered in the Crisis program are dependent upon the type of care provided, and may follow either Outpatient and Medical rates or CBS/CSS rates. See the business office for specific details.

Definitions

CBS: Community Based Services (for children and youth)

CSS: Community Support Services (for adults)

Crisis: Crisis Diversion Services (all ages)

FPL: Federal Poverty Level, a federally-determined income chart based on household size
 

Four County Mental Health Center

Customary Charges

 

Service TypeDuration/Service LevelCharge
Individual Therapy16-37 minutes$80
38-52 minutes$100
53+ minutes$160
Med Management
Level 1$30
Level 2$60
Level 3$85
Level 4$130
Level 5$210
Attendant CareEach 15 minutes$7.10
Admission EvaluationEach event$150
Case ConferenceEach event$100
CBST Screen AdvEach event$81.60
Competency EvaluationEach event$315
Continued Stay ScreeningEach event$3,053
Couples TherapyEach 15 minutes$25
Court TestimonyEach 15 minutes$25
CPST AdultEach 15 minutes$32.54
CPST ChildEach 15 minutes$32.54
CPST Employment SupportEach 15 minutes$34.07
CPST IDDTEach 15 minutes$35.39
CPST Strengths BasedEach 15 minutes$34.07
Crisis ScreenEach hour$200
Crisis AdvancedEach 15 minutes$44.37
Crisis BasicEach 15 minutes$22.19
Crisis IntermediateEach 15 minutes$35.50
DUI Diversion EvaluationEach event, includes fee$245
DUI EvaluationEach event$150
EC AssessmentEach event$137.50
EC InterventionEach 15 minutes$17.85
EC ScreenEach event$25.50
Family TherapyEach event$150
Gambling AssessmentEach event$150
Gamb Crisis InterEach 15 minutes$43.50
Gambling Family TherapyEach 15 minutes$25
Gambling Group TherapyEach 15 minutes$12.50
Gambling IndividualEach 15 minutes$25
Group TherapyMental Health per event$75
SUD per 15 minutes$12.50
InjectionEach event$35
SUD Case ManagementEach 15 minutes$25
SUD Peer Support GroupEach 15 minutes$7.85
SUD Peer Support IndEach 15 minutes$15.71
SUD EvaluationEach event$150
Parent EvaluationEach event$130
Medical EvalEach event$210
Parent Support GroupEach 15 minutes$3.33
Parent Support IndividualEach 15 minutes$11.09
PASRR ScreenEach event$345
Psych Rehab IndEach 15 minutes$13.90
PRTF ScreenEach event$150
Peer Support GroupEach 15 minutes$7.85
Peer Support IndEach 15 minutes$11.09
Psych Rehab Group-AdultEach 15 minutes$4.46
Psych Rehab Group-ChildEach 15 minutes$8.93
Psych TestingEach hour$130
Relapse & PreventionEach 15 minutes$8.75
Senate Bill Evaluation
Senate Bill Family Sess
SUD Support ServicesEach 15 minutes$8.00
Targeted Case ManagementEach 15 minutes$11.05
Treatment Plan16-37 minutes$80
38-52 minutes$100
53+ minutes$160
MH Walkin IntakeEach event$150
School Admission EvalEach event$150
School Ind Therapy16-37 minutes$80
38-52 minutes$100
53+ minutes$160
School Family TherapyEach event$150
School Group TherapyEach event$75
SUD General AssessmentEach event$150
TCM Tx PlanEach 15 minutes$11.05
CPST Tx PlanEach 15 minutes$32.54
Crisis Screen