Financials and Insurance

Initial Evaluation and Treatment Planning

After my review of screening forms and prior treatment records, we will meet together in the office for about an hour to begin the process of deciding how best to approach your treatment. I don’t usually prescribe medication after the first session (unless the patient is already taking medication and needs an urgent refill.) Additional studies such as laboratory, radiology, or psychological testing may be ordered.

Concierge Psychiatry Service ($1050 per month)

Psychotherapy works best when it is consistent and regular. The monthly fee includes:

  • One 40-50 minute psychotherapy session at the same time each week during regular business hours
  • Prescribing of all medically necessary psychiatric medications
  • Coordination with your primary care physician for all medical conditions, lab studies, or other testing
  • Anytime online scheduling to view, cancel or change your appointments
  • Anytime online patient portal for messaging, lab results and documents
  • Direct access to Dr. Grugle’s cell phone for urgent needs (in an emergency, call 911 first)
  • If hospitalization is required, Dr. Grugle will coordinate the admission process and see the patient on a daily basis. (Travel and inpatient attending / consultation fees apply)
  • If requested, we will handle claims for any insurance benefits you may be entitled to; any benefits we receive will be used to offset your monthly fee

There is no charge for weeks that Dr. Grugle is not in the office or in case of winter weather (if Dallas or your local Public Schools are closed.)

Additional Recurring Psychotherapy Sessions ($210)

Your progress in treatment may be enhanced by attending up to 4 sessions per week, which may be reserved in the same week on a recurring basis.

Additional Services

Non medically necessary services requested by the patient are not covered by insurance and are charged at a standard fee of $400 per hour (minimum $45). Examples of non-medically necessary services are completion of disability forms, FMLA forms, prescription pre-authorization appeals, completion of life insurance applications and duplication of medical records.

I am “opted out” of Medicare – Medicare will not reimburse any fees and you will not be able to file a claim.

I accept CIGNA insurance for a la carte appointments.


Your appointment time is reserved for you and you alone. The full office visit fee will be assessed for broken appointments or appointments canceled with less than 24 hours advance notice, unless the cancelled appointment can be filled with another patient’s visit. Cancellation fees are not usually covered by insurance. In case of winter weather, cancellation fees will not be charged if Dallas, Richardson or the patient’s Public Schools are closed.

A “standing appointment” is a regular, reserved time for a psychotherapy appointment that is reserved for the patient throughout the course of the patient’s treatment. That is, the time is reserved until treatment is discontinued and the patient gives notice that the time is no longer to be reserved. The patient will be billed for all standing appointments, whether or not they attend, unless the cancelled appointment can be filled with another patient’s visit, or unless the appointment is rescheduled at a mutually agreeable time within the same week. Given adequate notice I can almost always fill cancelled appointment slots, but that’s not guaranteed. In case of winter weather, cancellation fees will not be charged if Dallas, Richardson or the patient’s Public Schools are closed.

Concierge fees are non-refundable (no refunds for cancellations, though every effort will be made to reschedule during the same week); except in case of winter weather, missed session fees will be credited against the next month’s concierge fee if Dallas, Richardson or the patient’s Public Schools are closed.

Treatment Estimates
Patients may request a written estimate of their out-of-pocket expenses.  Charges may vary based on the patient’s condition. The request may delay the scheduling of your care.  The actual charges may differ from the amount paid by the third-party payer.  The patient is personally liable for the services not paid by health insurance.
Dr. Grugle will not furnish adverse information to consumer reporting agencies regarding amounts owed by the patient if the patient finalizes a payment plan agreement within 45 days of receiving the first statement. You may be able to reduce some of your out-of-pocket costs for an out-of-network medical or health care claim that is eligible for mediation by contacting the Texas Department of Insurance at and 1-800-252-3439.

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