Self-Pay Fee Schedule
We maintain a Standard Professional Fee Schedule for patients who are out-of-network, uninsured, or electing to self-pay.
If you are using insurance, we will instead bill your insurer our negotiated contract rate which is discounted from the standard fee. Please review your benefits with your insurance carrier to understand the out-of-pocket cost to you, which is often a small fraction of the rates described below.
1. Clinical Visits
These fees cover your clinical visits with your provider for diagnosis, medication management, and treatment oversight. The standard professional fee for visits is the same for video visits and audio-only visits
New Patient Initial Visit - $290
Established Patient Brief Follow-up - $235
Established Patient Standard Follow-up - $330
2. Monthly Overall Management
Ourera also provides services outside of your clinical visits to support your success and ensure that care remains safe and effective. These services may include coordination with other providers involved in your care, treatment plan development, supporting the treatment plan, providing you with counseling through secure messaging, and in some cases providing you with individual or group psychotherapy services when desired. Rather than bill for each individual service, we track time spent on these services and bill for total time each calendar month.
New Patient - Initial Calendar Month
Up to 69 minutes - included in clinical visit fees
70 to 119 minutes - $875
Beginning at 120 minutes, each 30-minute increment - $110
Established Patient - Any Calendar Month
Up to 59 minutes - included in clinical visit fees
60 to 119 minutes - $780
Beginning at 120 minutes, each 30 minute increment - $110
The 2-Part Fee Approach
Ourera’s fee schedule, including the Monthly Overall Management fee, is adapted from the way that Medicare and most insurance companies pay for addiction treatment services. Our rates are based directly on Medicare rates for the equivalent service. We review and update our rates when Medicare rates are updated.
A benefit to the 2-part approach is that it permits an accessibly low per-visit rate for patients with the most basic needs, while ensuring that comprehensive support can be provided as needed.
Total Cost Estimates
If you will be paying for your full cost of care without using insurance, Ourera will provide you with a personalized “good faith estimate” of your anticipated cost of care per month and per year.
In general:
A new patient in their first month of care should expect at least one New Patient Visit and one Standard Follow-up Visit. There may be 1-2 additional Brief Follow-up Visits in the first month when needed, such as when starting a new buprenorphine prescription.
An established patient should expect at least one Standard Follow-up Visit each month. There may be 1-2 additional Brief Follow-up Visits in a month when needed.
Monthly Overall Management fees depend on your preferences, your level of engagement outside of visits, and the overall complexity of your care.