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Cost · out-of-network · CaliforniaHow much does virtual IOP cost?
There is no single price, and any program that gives you one before reading your plan is guessing. Three numbers inside your own policy set what you owe. We read them and put the figure in writing before you start.
Your plan sets the number, not the program.
Shift is out-of-network with the commercial carriers. On an out-of-network claim the amount you owe comes out of three figures in your own policy: the out-of-network deductible, the coinsurance percentage after the deductible is met, and the out-of-pocket maximum that caps the year. Two people in the same cohort on two different cards can owe very different amounts.
So we run the benefit check first, usually inside the same business day, and hand you a plain-English estimate before anyone asks you to commit. Private pay is available, and the rate for it is quoted on the call rather than on this page, because it depends on the level of care the clinical screen lands on.
If Medi-Cal is your coverage we cannot bill it, and we will say so on the first call and point you to a county provider rather than leave you with nothing.
The parts of your plan that decide it.
What you pay before the plan pays anything toward out-of-network care. On most plans it is a separate, higher number than the in-network deductible.
Your percentage share once the deductible is met. The plan sets the percentage, not the program.
The ceiling for the plan year. Past it, the plan carries the rest.
The figure the plan applies those percentages to. It is not the same as the billed charge, and the gap between the two is the part most members are never shown.
Outpatient, intensive outpatient and ambulatory withdrawal management are billed differently. The clinical screen decides which one you need.
Many plans review intensive outpatient care before it starts. An unauthorized start is the most common reason a claim is denied.
A written estimate after the benefit check, before the first session.
Available. The rate is quoted on the call once the level of care is known.
We cannot bill either today. We will tell you on the first call and point you somewhere that can.
Benefit check usually the same business day, often inside an hour.
We read your plan before you commit to anything.
Covered by many PPO plans. We check your benefits first.
Shift bills most major commercial plans on an out-of-network basis, and in-network credentialing is in process. We read your plan, tell you what it pays toward intensive outpatient care, and give you that number in writing before your first appointment.
Medi-Cal. We cannot bill Medi-Cal today, because we hold no county contract yet. If Medi-Cal is your coverage, tell us and we will point you to a county provider who can help now.
More on coverage: what it costs, what out-of-network means, your carrier.
The ones people ask first.
How much does IOP cost without insurance?
We quote private pay on the call rather than publishing a rate, because the figure follows the level of care that the clinical screen lands on. Ask for it on the first call and you will have it before you decide anything.
Does insurance cover IOP?
Most commercial plans, union health funds, federal plans and self-funded employer plans include an out-of-network behavioral health benefit. Whether yours pays well, and what it pays toward intensive outpatient care, is exactly what the benefit check answers. See the carrier-by-carrier look.
Is virtual IOP cheaper than in-person IOP?
The same procedure codes are billed either way, so the rate is not where the difference sits. What a virtual program removes is the drive, the parking, the childcare hours and the time off work around each session.
How do I find out what my own plan pays?
Send us the front and back of the card and the policy holder's details and we will run it, or call the behavioral health number on the card yourself and ask for the out-of-network intensive outpatient benefit. The out-of-network guide has the script.
Can I get the cost in writing before I start?
Yes. That is the point of the estimate, and you are also entitled to a good faith estimate under federal law. See the No Surprises Act notice.
Get the number before you decide.
Send the card, we read the plan, you get a written estimate. No commitment attached to any of it.
If you or someone you are with is in immediate danger, call or text 988 (the Suicide and Crisis Lifeline) or call 911. Shift Support Network is an outpatient program and is not an emergency service. Related: Coverage · Out-of-network · What out-of-network means · Good faith estimate.