Sliding Fee Scale
Sliding Fee
| Service Provided | A | B | C | D | Full Fee |
| Individual Therapy | $30 | $40 | $50 | $60 | $90 |
| Psychiatric Evaluation | $30 | $40 | $50 | $60 | $90 |
| Follow up Psychiatry Visit | $60 | $80 | $100 | $120 | $140 |
Toggle between ‘A’ ‘B’ ‘C’ ‘D’ to view scale
| Category | 0-100% of FPL | |
| Family Size | Monthly Income | Annual Income |
| 1 | 0.00-1,304 | 0.00-$15,650.00 |
| 2 | 0.00-1,763 | 0.00-$21,150.00 |
| 3 | 0.00-2,221 | 0.00-$26,650.00 |
| 4 | 0.00-2,679 | 0.00-$32,150.00 |
| 5 | 0.00-3,138 | 0.00-$37,650.00 |
| 6 | 0.00-3,596 | 0.00-$43,150.00 |
| 7 | 0.00-4,054 | 0.00-$48,650.00 |
| 8 | 0.00-4,513 | 0.00-$54,150.00 |
| Each Additional Person add | 458 |
$5,500 |
=
| Category | 101-135% of FPL | ||
| Family Size | Monthly Income | Annual Income | |
| 1 | 1,305 – $1761 | $15,650.01 – $21,127.50 | |
| 2 | 1,764 – $2,379 | $21, 150.01 – $28,552.50 | |
| 3 | 2,222 – $2,998 | $26,650.01 – $35,977.50 | |
| 4 | 2,680 – $3,617 | $32,150.01 – $43,402.50 | |
| 5 | 3,139 – $4,236 | $37,650.01 – $50,827.50 | |
| 6 | 3,597 – $4,854 | $43, 150.01 – $58,252.50 | |
| 7 | 4,055 – $5,473 | $48, 650.01 – $65,677.50 | |
| 8 | 4,514 – $6,092 | $54,150.01 – $73,102.50 | |
| Each Additional Person add | $619 | $7,425 | |
| Category | 136-165% of FPL | |
| Family Size | Monthly Income | Annual Income |
| 1 | $1,762-$2,152 | $21,127.51-$25,822.50 |
| 2 | $2,380-$2,908 | $28,552.51 -$34,897.50 |
| 3 | $2,999-$3,664 | $35,977.51-$43,972.50 |
| 4 | $3,618-$4,421 | $43,402.51-$53,047.50 |
| 5 | $4,237-$5,177 | $50,827.51-$62,122.50 |
| 6 | $4,855-$5,933 | $58,252.51-$71,197.50 |
| 7 | $5,474-$6,689 | $65,677.51-$80,272.50 |
| 8 | $6,093-$7,446 | $73,102.51-$89,347.50 |
| Each Additional Person add | $756 | $9,075 |
| Category | 166-200% of FPL | |
| Family Size | Monthly Income | Annual Income |
| 1 | $2,153 – $2,608 | $25,822.51 – $31,300.00 |
| 2 | $2,909 – $3,525 | $34,897.51 – $42,300.00 |
| 3 | $3,665 – $4,442 | $43,972.51 – $53,300.00 |
| 4 | $4,422 – $5,358 | $53,047.51 -$64,300.00 |
| 5 | $5,178 – $6,275 | $62,122.51 – $75,300.00 |
| 6 | $5,934 – $7,192 | $71,197.51 – $86,300.00 |
| 7 | $6,690 – $8,108 | $80,272.51 – $97,300.00 |
| 8 | $7,447 – $9,025 | $89,347.51 – $108,300.00 |
| Each Additional Person add | $917 | $11,000 |
| Full Fee 201% of FPL & Over |
Note:
Monthly and Annual Incomes that are above the limits in Slide Category D are ineligible for the sliding fee scale program and are charged the full amount of standard fees.