Sliding Fee Scale
Sliding Fee
| Service Provided | A | B | C | D | Full Fee |
| Individual Therapy | $30 | $40 | $50 | $60 | $90 |
| Psychiatric Evalution | $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 | 0.00-1,215 | 0.00-$14,580.00 |
| 2 | 0.00-1,643 | 0.00-$19,720.00 |
| 3 | 0.00-2,072 | 0.00-$24,860.00 |
| 4 | 0.00-2,500 | 0.00-$30,000.00 |
| 5 | 0.00-2,928 | 0.00-$35,140.00 |
| 6 | 0.00-3,357 | 0.00-$40,280.00 |
| 7 | 0.00-3,785 | 0.00-$45,420.00 |
| 8 | 0.00-4,213 | 0.00-$50,560.00 |
| Each Additional Person add | 428 |
$5,140 |
| Category | 101-135% of FPL | |
| Family Size | Monthly Income | Annual Income |
| 1 | 1,216-$1,640 | $14,580.01-$19,683.00 |
| 2 | 1,644-$2,219 | $19,720.01-$26,622.00 |
| 3 | 2,073-$2,797 | $24,860.01-$33,561.00 |
| 4 | 2,501-$3,375 | $30,000.01-$40,500.00 |
| 5 | 2,929-$3,953 | $35,140.01-$47,439.00 |
| 6 | 3,358-$4,532 | $40,280.01-$54,378.00 |
| 7 | 3,786-$5,110 | $45,420.01-$61,317.00 |
| 8 | 4,214-$5,688 | $50,560.01-$68,256.00 |
| Each Additional Person add | $578 | $6,939 |
| Category | 136-165% of FPL | |
| Family Size | Monthly Income | Annual Income |
| 1 | $1,641-$2,005 | $19,683.01-$24,057.00 |
| 2 | $2,220-$2,712 | $26,622.01-$32,538.00 |
| 3 | $2,798-$3,418 | $33,561.01-$41,019.00 |
| 4 | $3,376-$4,125 | $40,500.01-$49,500.00 |
| 5 | $3,954-$4,832 | $47,439.01-$57,981.00 |
| 6 | $4,533-$5,539 | $54,378.01-$66,462.00 |
| 7 | $5,111-$6,245 | $61,317.01-$74,943.00 |
| 8 | $5,689-$6,952 | $68,256.01-$83,424.00 |
| Each Additional Person add | $707 | $8,481 |
| Category | 166-200% of FPL | |
| Family Size | Monthly Income | Annual Income |
| 1 | $2,006-$2,430 | $24,057.01-$29,160.00 |
| 2 | $2,713-$3,287 | $32,538.01-$39,440.00 |
| 3 | $3,419-$4,143 | $41,019.01-$49,720.00 |
| 4 | $4,126-$5,000 | $49,500.01-$60,000.00 |
| 5 | $4,833-$5,857 | $57,981.01-$70,280.00 |
| 6 | $5,540-$6,713 | $66,462.01-$80,560.00 |
| 7 | $6,246-$7,570 | $74,943.01-$90,840.00 |
| 8 | $6,953-$8,427 | $83,424.01-$101,120.00 |
| Each Additional Person add | $857 | $10,280 |
| 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.