Sliding Scale Fees

Sliding Scale Fees 2017-10-04T21:01:12+00:00

Cascadia Behavioral Healthcare Mental Health Sliding Scale Tables

How to Use the Self Pay Program-

First, look up income and family size on Table 1 and note the letter of the Payment Code Letter

Table 1- Monthly Income Categories

Payment Code:
Payment %
(A)
0% Pay
(B)
15% Pay
(C)
40% Pay
(D)
75% Pay
(E)
100% Pay
Family Size 1 $0-
$1,005
$1,006-
$1,508
$1,509-
$2,010
$2,011-
$2,513
$2,514-
+
2 $0 –
$1,353
$1,354-
$2,030
$2,031-
$2,706
$2,707-
$3,383
$3,384-
+
3 $0-
$1,702
$1,703-
$2,553
$2,554-
$3,404
$3,405-
$4,255
$4,256-
+
4 $0-
$2,050
$2,051-
$3,075
$3,076-
$4,100
$4,101-
$5,125
$5,126-
+
5 $0-
$2,398
$2,399-
$3,597
$3,598-
$4,796
$4,797-
$5,995
$5,996-
+
6 $0-
$2,747
$2,748-
$4,121
$4,122-
$5,494
$5,495-
$6,868
$6,869-
+
7 $0 –
$3,095
$3,096 –
$4,643
$4,644 –
$6,190
$6,191 –
$7,738
$7,739 –
+
8 $0 –
$3,443
$3,444 –
$5,165
$5,166 –
$6,886
$6,887 –
$8,608
$8,609 –
+

Next, lookup the service in Table 2 and see how much the rate of payment will be based on the Payment Code.

Table 2- Self Pay Program 2d1.2

PAYMENT CODE:
PAYMENT %:
MHSS0
0% Pay
MHS15
15% Pay
MHS40
40%
MHS75
75% Pay
MH100
100% Pay
Psychiatric Intake Eval/
Assessment 90791
(per occurrence)
$0 $27 $73 $137 $182
Individual (MH and SUD)
120 (per 15 minutes)
$0 $5 $14 $26 $35
Family (MH and SUD)
220 (per occurrence)
$0 $21 $56 $106 $141
Group Counseling (MH/SUD)
200 (per occurrence)
$0 $20 $20 $68 $90
Mental Health/A&D Assessment
240 (per occurrence)
$0 $32 $84 $158 $211
Nurse/Full 142
(per 15 minutes)
$0 $5 $14 $26 $35