• 75-minute evaluation: $295

• 60-minute follow-up: $270

Duende is an out-of-network provider and does not accept insurance directly. I can provide a superbill — an invoice you can submit to your insurance, HSA, or FSA for possible reimbursement. Not all plans reimburse out-of-network visits, so it's worth checking with yours beforehand.

If you have a high-deductible plan, you usually pay out of pocket for every visit until you meet your deductible, so seeing me may cost less than an in-network provider charging a higher per-visit rate (like a hospital system).

If you have Medicare: by law, I'm not able to accept cash payment or provide a superbill for reimbursement.

To help make care more accessible, I set aside five sliding-scale appointment slots each week. Sliding-scale visits are the same length and the same care as every other visit. If all five are taken, I'll put you on a waitlist and let you know when one opens. Any sliding-scale slot still available three days before the appointment opens to all patients. 

If your household income is at or below 500% of the Federal Poverty Level (FPL), you're eligible for a sliding-scale rate:

0–90% of FPL: 60% off (evaluation $118, follow-up $108)

91–100% of FPL: 50% off (evaluation $147, follow-up $135)

101–200% of FPL: 40% off (evaluation $177, follow-up $162)

201–300% of FPL: 30% off (evaluation $206, follow-up $189)

301–400% of FPL: 20% off (evaluation $236, follow-up $216)

401–500% of FPL: 10% off (evaluation $265, follow-up $243)

Not sure where you fall? Email me your household size and income and I'll tell you your rate — no need to do the math yourself. (Or check the 2026 federal guidelines if you'd like to calculate it.)

Before your first visit, I'll ask for something that shows your income, like a recent tax return, pay stubs, or a benefits letter. I only use it to confirm your rate, and I don't keep a copy. If you don't have any of those, tell me your situation and we'll figure it out.

Questions? Reach out — happy to help.