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
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 Type | Duration/Service Level | Charge |
| Individual Therapy | 16-37 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 Care | Each 15 minutes | $7.10 |
| Admission Evaluation | Each event | $150 |
| Case Conference | Each event | $100 |
| CBST Screen Adv | Each event | $81.60 |
| Competency Evaluation | Each event | $315 |
| Continued Stay Screening | Each event | $3,053 |
| Couples Therapy | Each 15 minutes | $25 |
| Court Testimony | Each 15 minutes | $25 |
| CPST Adult | Each 15 minutes | $32.54 |
| CPST Child | Each 15 minutes | $32.54 |
| CPST Employment Support | Each 15 minutes | $34.07 |
| CPST IDDT | Each 15 minutes | $35.39 |
| CPST Strengths Based | Each 15 minutes | $34.07 |
| Crisis Screen | Each hour | $200 |
| Crisis Advanced | Each 15 minutes | $44.37 |
| Crisis Basic | Each 15 minutes | $22.19 |
| Crisis Intermediate | Each 15 minutes | $35.50 |
| DUI Diversion Evaluation | Each event, includes fee | $245 |
| DUI Evaluation | Each event | $150 |
| EC Assessment | Each event | $137.50 |
| EC Intervention | Each 15 minutes | $17.85 |
| EC Screen | Each event | $25.50 |
| Family Therapy | Each event | $150 |
| Gambling Assessment | Each event | $150 |
| Gamb Crisis Inter | Each 15 minutes | $43.50 |
| Gambling Family Therapy | Each 15 minutes | $25 |
| Gambling Group Therapy | Each 15 minutes | $12.50 |
| Gambling Individual | Each 15 minutes | $25 |
| Group Therapy | Mental Health per event | $75 |
| SUD per 15 minutes | $12.50 | |
| Injection | Each event | $35 |
| SUD Case Management | Each 15 minutes | $25 |
| SUD Peer Support Group | Each 15 minutes | $7.85 |
| SUD Peer Support Ind | Each 15 minutes | $15.71 |
| SUD Evaluation | Each event | $150 |
| Parent Evaluation | Each event | $130 |
| Medical Eval | Each event | $210 |
| Parent Support Group | Each 15 minutes | $3.33 |
| Parent Support Individual | Each 15 minutes | $11.09 |
| PASRR Screen | Each event | $345 |
| Psych Rehab Ind | Each 15 minutes | $13.90 |
| PRTF Screen | Each event | $150 |
| Peer Support Group | Each 15 minutes | $7.85 |
| Peer Support Ind | Each 15 minutes | $11.09 |
| Psych Rehab Group-Adult | Each 15 minutes | $4.46 |
| Psych Rehab Group-Child | Each 15 minutes | $8.93 |
| Psych Testing | Each hour | $130 |
| Relapse & Prevention | Each 15 minutes | $8.75 |
| Senate Bill Evaluation | ||
| Senate Bill Family Sess | ||
| SUD Support Services | Each 15 minutes | $8.00 |
| Targeted Case Management | Each 15 minutes | $11.05 |
| Treatment Plan | 16-37 minutes | $80 |
| 38-52 minutes | $100 | |
| 53+ minutes | $160 | |
| MH Walkin Intake | Each event | $150 |
| School Admission Eval | Each event | $150 |
| School Ind Therapy | 16-37 minutes | $80 |
| 38-52 minutes | $100 | |
| 53+ minutes | $160 | |
| School Family Therapy | Each event | $150 |
| School Group Therapy | Each event | $75 |
| SUD General Assessment | Each event | $150 |
| TCM Tx Plan | Each 15 minutes | $11.05 |
| CPST Tx Plan | Each 15 minutes | $32.54 |
| Crisis Screen |