Services & Fees
Clinicians at ECS provide individualized, evidence-based therapy and consultation services for children, adolescents, and adults experiencing Selective Mutism, anxiety, and other mental health concerns. Services are tailored to the needs of each individual and family and may take place in the office, virtually, or in the child’s natural environments, including home, school, and the community.
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The initial diagnostic and intake session is an information-gathering appointment designed to develop a comprehensive understanding of the client’s current concerns and treatment needs. The clinician reviews relevant developmental and medical history, previous therapy and interventions, family mental health history, the onset and presentation of current symptoms, factors that may contribute to the maintenance of symptoms, and the client’s communication abilities across settings and communication partners.
Parents and caregivers are invited to share their primary concerns, treatment goals, and expectations for therapy. For children presenting with Selective Mutism, the evaluation also includes a detailed assessment of verbal and nonverbal communication across different environments and social situations to help guide individualized treatment planning.
Fee: $250
CPT Code: 90791 -
Following the initial intake and diagnostic evaluation, the clinician meets with parents/caregivers to review the clinical impressions, diagnostic considerations and rule-outs, symptom severity, and recommended treatment plan. This session provides an opportunity for parents/caregivers to develop a clear understanding of their child’s diagnosis and the factors that may contribute to the onset and maintenance of symptoms.
The clinician provides individualized psychoeducation regarding the diagnosis and reviews the evidence-based interventions that will be used throughout treatment. Parents/caregivers will also receive practical guidance on how to respond to anxiety and communication difficulties in everyday situations and how to support their child’s progress without inadvertently increasing pressure or reinforcing avoidance.
Sessions are tailored to the specific needs of each child and family and may address questions such as:
“What should I do when someone asks my child a question and they freeze? Should I answer for them, encourage them to speak, or explain that they’re shy?”
“How can I help my child participate in the classroom and social activities even when they aren’t yet ready to use their voice?”
“How do I support brave communication without putting too much pressure on my child?”
“How can I respond when my child avoids situations that make them anxious?”
The goal of parent education is to equip caregivers with a better understanding of their child’s anxiety and practical strategies they can use at home, school, and in the community to promote confidence, participation, and meaningful progress.
Fee: $150/hour
CPT Code: 90837 -
Individual therapy is designed to address the unique needs and goals of each client. Treatment may incorporate evidence-based approaches such as PCIT-SM, Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and individualized exposure-based interventions. For children, treatment includes parent or caregiver involvement to help support progress outside of sessions. Individual therapy for adolescents and adults is tailored to their developmental needs and may focus on Selective Mutism, anxiety, confidence, communication, and other mental health concerns.
Fee: $150/hour
CPT Code: 90837 -
Small-group therapy provides children and adolescents with opportunities to practice communication and social skills in a supportive, structured environment. Groups may focus on building confidence, increasing verbal communication, navigating social situations, and practicing skills with peers. Groups are designed to provide meaningful opportunities for children to experience success while gradually increasing their comfort with speaking and interacting with others.
CPT Code: 90853
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By nature of the SM diagnosis, progress made in one domain (e.g., the office) does not always generalize to other domains (e.g., home, community). The clinician will therefore meet the parent/caregiver and child in each domain as needed to work on generalizing progress to those areas.
Community sessions typically occur in places like coffee shops, playgrounds, and ice cream stores. A communication goal is created and practiced in the office or at home first. The therapist then meets the family at the decided upon location to help support the child and parent/caregiver in following through and completing the goal using the specific PCIT-SM interventions.
Starting at $175/hour + Travel
CPT CODE: 90837
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School can be a challenging environment for a child with Selective Mutism to navigate independently. For parents and caregivers, understanding how to access school-based resources, request accommodations, and determine whether an IEP or 504 Plan may be appropriate can feel equally overwhelming. Effective treatment often requires a collaborative team approach, and strong communication between the family, school, and clinician can make a meaningful difference in a child’s progress.
Through school consultation and training, the clinician works directly with your child’s educational team, either virtually or in person. Services may include training for teachers, school counselors, speech-language pathologists, and other school staff on Selective Mutism, including an overview of the diagnosis, how anxiety impacts communication and participation, and specific evidence-based strategies to reduce anxiety and support communication at school.
The clinician may also collaborate with school staff to develop an individualized treatment plan, including appropriate goals, expectations, and strategies that allow your child to build communication skills gradually and at their own pace. The focus is on creating supportive opportunities for participation and verbal communication without placing unnecessary pressure on the child.
When appropriate, the clinician can also provide direct, school-based therapy sessions with your child. These sessions allow treatment to take place within the environment where communication difficulties occur and provide opportunities to work directly on individualized communication goals with teachers, peers, and other important people in the child’s school environment. School-based treatment may include individualized exposure activities, building comfort with new communication partners and settings, practicing verbal communication, and helping your child generalize skills developed in therapy to the school setting.
When appropriate, the clinician can also support families in navigating the special education process, including requesting and preparing for IEP or 504 meetings. The clinician may participate in these meetings to provide education about Selective Mutism, collaborate with the school team, and help develop appropriate goals, accommodations, and supports related to social participation and verbal communication.
Starting at $175/hour + travel
CPT Code: 90837
Choosing to go out of network can be expensive. You should always first contact your insurance carrier to see if there is a provider in-network in your area that can address you or your child’s therapeutic needs.
On the back of your insurance card, locate the member services phone number. Call and ask for a list of in-network clinicians who are certified to treat Selective Mutism or the specific anxiety disorder for which you are looking to receive support.
You should be provided with a list of clinicians in your area that are in-network. When you call clinicians from this list, ask questions such as: Are they taking new patients? What treatment approach do they use? Do they specifically use evidence-based treatments, and if so, which ones? How much experience do they have treating Selective Mutism?
If there is no provider within a reasonable mile radius within your insurance network that specializes in or is certified to treat selective mutism, ask about an in-network exception.
An in-network exception (also called “single case agreement” or “gap exception” though could have other names depending on your insurance) is when your insurance will cover services by an out-of-network provider as if they were in-network. This means your reimbursement rate would fall under what is listed in the in-network column of your health benefits information.
When is it cost effective to go out of network?
It may be more cost effective in the long run to see a specialist for your specific therapeutic needs who can quickly and effectively treat the condition. Many clients at ECS will start with us, and then step down to in-network care for maintenance of their treatment gains. Our specialists are available to raise awareness of Selective Mutism and its treatment through consultations and training sessions with your in-network provider.
Treatment at ECS is meant to be short-term. If you see someone who is in-network but who does not specialize in treating the diagnosis, treatment may go on longer than it would with a specialist. This can create additional financial costs as well as greater social-emotional costs to you and your child.
It may be time to consider other options and look for a specialist who is out of network if (a) you have been working with an in-network provider and you are seeing limited progress, (b) any progress you have seen does not transfer to other settings (e.g., school or community), or (c) if you/your child’s symptoms are severe and the “usual and customary” in-network therapy is helping you/your child survive but not thrive.
What is a Flexible Spending Account (FSA) or a Health Savings Account (HSA)?
A Health Savings Account (HSA) or a Flexible Spending Account (FSA) allows you to pay for out-of-pocket health care costs with pre-tax dollars. When elected with your insurance policy, you typically receive a physical debit card that you can use to pay for health care services, and the amount is pulled from your health care savings account. ECS accepts payment from an FSA or HSA card.
ECS is a cash only practice. We do not work directly with insurance because the evidence-based treatment largely used at the practice—PCIT-SM—is considered a specialty service that does not fit within the “usual and customary” services that insurance plans cover as in-network services. However, this does not mean that insurance companies will not cover our treatment. Many policies have out of network benefits that will reimburse you for some or all of the cost of the session.
After a session with ECS, you will be charged the full fee for the session. You will then be provided with an insurance-reimbursable statement that you can submit to your insurance under out-of-network services.
We understand that treatment at ECS is a significant investment. If you are interested in working with us, here are a few things to consider: