Fees & Policies
Clinic Policies and Fee Schedule
Please review the following financial policies and fee schedule for standard care. Membership plans are available for those seeking advanced and concierge-level care.
Standard Care
Service Fees
Initial Evaluation
60 minutes
$495
for out-of-network and self-pay clients
Review of completed forms and prior records, psychiatric interview, collateral information, diagnostic formulation, and treatment recommendations.
Available within 10 business days
Medication Management
30 minutes
$250
for out-of-network and self-pay clients
Review of responses to psychiatric medications, recommendations for changes or augmentations. Includes Medication Assisted Treatment (MAT) for substance-use disorders.
Available within 5 business days
TMS (Depression)
30 minutes per session
$8,500
for 36 sessions (out-of-network and self-pay)
Five sessions per week for six weeks followed by a four-week taper. 30–36 sessions depending on insurance approval.
TMS (Off-Label)
30 minutes per session
$1,200 / $2,400
5 sessions / 10 sessions
For Autism, Bipolar, PTSD, ADHD, anxiety, migraines, cognitive impairment, and other conditions. Short-course option to bypass additional medication trials or insurance regulations.
IM or IV Ketamine
120 minutes
$250 / $700
with qualifying insurance / out-of-network & self-pay
Two sessions per week for four weeks, followed by once-weekly maintenance for four weeks. Includes up to 100mg of ketamine. Additional ketamine billed at $0.50/mg.
ADHD Evaluation
3 sessions
$200
QB testing supplemental charge (regardless of insurance)
Clinical interview (90 min), QB testing (30 min), and results review (30 min) with treatment recommendations.
No-Shows and Missed Appointments
Missing an appointment without appropriate notice impacts three people: yourself, the provider, and another client who would have benefited from that appointment time. Missed appointments are billed directly to the client for the self-pay cost of the appointment, regardless of insurance status. Appointments must be cancelled at least 48 hours in advance.
Missed/Late Cancelled Initial Evaluation
$495
Missed/Late Cancelled Follow-Up (30 min)
$250
Missed/Late Cancelled Follow-Up (60 min)
$495
Missed/Late Cancelled Ketamine (120 min)
$700
Missed/Late Cancelled Initial TMS (60 min)
$400
Missed/Late Cancelled TMS (30 min)
$300
Up to 2 TMS sessions courtesy permitted at no charge
Administrative
Practice Policies
Card on File
To become a client, your card information will be saved on file and will be charged in the event of a missed appointment or late cancellation. Copays and deductibles are due at time of booking. Clients will be contacted and will not be automatically charged for outstanding balances.
If a card is declined, a $95 service fee will apply if not resolved within 48 hours of notification. Failure to resolve payment will result in termination from the practice and your outstanding balance will be sent to a third-party collection agency.
Termination Policy
At times, terminating the physician-patient relationship is necessary. Termination may be initiated by either the patient or doctor. Reasons for termination by the physician are generally due to patient non-compliance with treatment(s), missed appointments or multiple cancellations, unpaid outstanding balances, or in rare cases, inability to continue the therapeutic relationship.
Dr. Ene-Stroescu will continue to provide medication refills for up to 30 days after a notice of termination to allow you to find a new physician.
Discontinuation of Advanced Treatment
For those who elect to pursue time-intensive services such as Vivitrol, TMS, Ketamine, and Spravato and do not begin, become unreachable, or drop out prior to completion of the treatment plan — for reasons deemed appropriate by the provider or a documented hardship (e.g., loss of employment or insurance coverage) — are subject to a $195 service fee plus the self-pay cost for the remainder of the scheduled sessions.
Accommodation Paperwork
We are happy to provide and complete accommodation paperwork such as for FMLA, PFMLA, or related documentation. As this takes additional time outside of scheduled sessions, a $95 administrative service fee will apply.
Legal Services
Legal Fees
Participation in legal proceedings is distinct from clinical care and requires significant time for preparation, coordination, and court appearance. Advanced payment is required.
Preparation / Record Review / Attorney Meetings
$1,000/hour
Court Testimony Retainer
$4,000
Minimum 4 hours, paid in advance. Non-refundable if court date is cancelled. An additional $4,000 applies if rescheduled.
Additional Hours or Delayed Proceedings
$1,000/hour
Medication Refills
For refill requests, please send a message in the patient portal, via text to 253-336-7996, via email to support@axiostms.com, or by calling our office at 253-445-2385. Be mindful of when you are running low — refill requests may be contingent on having another appointment scheduled (especially for controlled substances), and are generally attended to within 3 business days.
Insurance & Self-Pay
Understanding Your Payment Options
In-Network Insurance
We are in-network with Aetna, Premera, Regence, other Blue Cross Blue Shield plans, Cigna, and Kaiser.
Review your copay and deductible obligations prior to booking.
Out-of-Network & Self-Pay
We are not in-network with United Healthcare, Tricare, VA, Medicare, Medicaid, Molina, Ambetter, or other state/community health plans.
You may be eligible for partial reimbursement through your out-of-network benefits. Ask our staff to provide a Superbill, and we will gladly assist with this process.
Questions About Fees or Policies?
Our team is happy to walk you through the details. Contact us with any questions.