David C. Lichti, LMFT

Forms and Fees

Forms:
MFT Group Form (Microsoft Word Document)
Personal Information Sheet (PDF)
Referral Information for Minors (PDF)

If you need a PDF reader, feel free to download Adobe Reader from Adobe's site:
Adobe Reader Download

Accepted Insurance Plans:

BlueCross and/or BlueShield
Health Net
MHN/Managed Health Network
Victim Witness
Verify your health insurance
coverage when you arrange your first visit.

Fees:

Fees & Insurance

Session Fees:

Individual Sessions: (45-60 mins: $65 -$85)
First Diagnostic Assessment Session: (90 mins: $85-$100)
Family Sessions: (50-80 mins: $$85-$120)
Group Sessions: (50 mins: $20-40)

Insurance
Services may be covered in full or in part by your health insurance or employee benefit plan. Please check your coverage carefully by asking the following questions:

Do I have mental health insurance benefits?
What is my deductible and has it been met?
How many sessions per year does my health insurance cover?
What is the coverage amount per therapy session?
Is approval required from my primary care physician?

Insurance Plans Accepted

Anthem
Blue Shield, Blue Cross
Healthnet
Single Case Agreements- With other PPO/HMO plans
Fee for service- you can seek reimbursement from your insurance plan, if I am not a provider.

Reduced Fee
Reduced fee services are available.

Payment
Cash, and check accepted for payment.

Cancellation Policy
If you do not show up for your scheduled therapy appointment, and you have not notified me at least 24 hours in advance, you will be required to pay half of the full cost of the session.