Insurance and Fees for Therapy
We offer two ways to work together depending on your needs and location.
Adaptive Therapeutic Solutions (ATS) provides insurance-based psychotherapy for clients located in Montana and Colorado.
The Anxiety Break offers private-pay coaching and consultation for individuals, families, and professionals across the United States.
Both approaches draw from the same evidence-based principles, including ERP, ACT, SPACE, and other behavioral strategies, but they differ in structure, documentation, and availability depending on your needs.
Adaptive Therapeutic Solutions
Model
Insurance-based psychotherapy
Best for…
Ongoing therapy clients meeting medical necessity.
What’s Offered
ERP, ACT, I-CBT, DBT, trauma-informed care, diagnosis, and treatment.
Documentation
Full clinical documentation and diagnosis
Where I Can Serve You
Montana and Colorado (licensed therapy only).
The Anxiety Break
Model
Coaching & Consultation
Best for…
Coaching for individuals/families using ERP/ACT principles (non-diagnostic)
What’s Offered
ERP- and ACT-informed strategies, DBT-based tools, SPACE and Family Well-Being parent coaching frameworks, exposure support, values-based work, professional consultation
Documentation
No diagnosis or treatment plan
Where I Can Serve You
All 50 states (non-clinical services)
Not sure which path fits? Email us and we’ll help you figure out the best fit—no pressure.
Fees
Psychotherapy (ATS)
Initial assessment: $275
53-minute therapy session: $225
Insurance
In-network with: BCBS, Allegiance/Cigna, Aetna, Mountain Health CO-OP, PacificSource, and First Choice Health.
Availability for new insurance-based clients is very limited and varies by referral and insurance plan. Some plans are currently closed to new patients.
Private Pay
A limited number of private-pay appointments are reserved for new clients. Private-pay availability may differ from insurance-based availability.
If you have a plan Michelle is in-network with, your plan’s rules may affect whether you can choose to self-pay instead of using your benefits. We’ll help you sort out your options before scheduling. If you choose not to use your insurance benefits, sessions are not billed to insurance and a superbill is not provided.
Out-of-Network Benefits
If Michelle is not in-network with your plan and it includes out-of-network mental health benefits, a superbill may be available for you to submit for possible reimbursement. Coverage and reimbursement are determined by your insurance company and are not guaranteed. This can be discussed before scheduling.
Coaching & Consultation (The Anxiety Break)
50-minute session: $225
No insurance or documentation
May include individual coaching, parent consultation, or clinical/professional consultation
Services can include individual coaching, family consultation, or skills-based guidance using ERP, ACT, DBT, SPACE, and Family Well-Being principles.
Contracts available for some family or consultation services
Text for more information
Court-Ordered Evaluations & Legal Services
These services are billed independently of therapy or coaching and follow a separate fee structure:
Psychosexual Evaluation (Court-Ordered): $2500 flat fee
Expert Witness Testimony: Fee negotiated based on scope, jurisdiction, and time commitment
Fact Witness Testimony: $1000 per half-day in court, plus preparation time and mileage
Please email us to request a proposal or legal services agreement. Michelle Puerner provides all Court-Ordered or Legal Services and will speak to you about the cost of services.
Working With Children and Families
I work with children ages five and up, teens, and their families. When treating anxiety and OCD in younger clients, parent involvement is often an important part of treatment.
Anxiety does not only affect the child. It often becomes part of family routines, reassurance patterns, and accommodations that develop over time. Because of this, treatment frequently includes parent participation.
The first appointment for pediatric clients is typically a parent session focused on evaluation and understanding the child’s symptoms, history, and family patterns. This allows time to gather important information and discuss how anxiety or OCD may be functioning within the family system.
The second appointment usually includes meeting with the child or teen. Ongoing treatment may include individual sessions with the child, parent sessions, or a combination of both depending on the needs of the family.
I often incorporate elements of the SPACE program (Supportive Parenting for Anxious Childhood Emotions). SPACE helps parents reduce accommodations that unintentionally reinforce anxiety while supporting their child in building tolerance for distress.
If a child or teen is resistant to therapy, parent-based approaches can be effective. Many families begin with parent sessions and later transition the child into therapy once the environment around the anxiety begins to shift.
Good Faith Estimate
Under the No Surprises Act, all clients not using insurance have the right to receive a Good Faith Estimate (GFE) that outlines the expected cost of services.
You have the right to receive a GFE in writing at least 1 business day before your first session, or upon request at any point in your care. This estimate will include the total anticipated costs of services over a defined period, based on your current goals and service plan.
If you receive a bill that is at least $400 more than your GFE, you can dispute the charges.
For more information about your rights under the No Surprises Act, visit: www.cms.gov/nosurprise
Ethical Statement
We maintain full alignment with licensing laws and scope-of-practice regulations across all states. The distinction between therapy and coaching is clearly maintained to ensure transparency, ethics, and client safety.