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Rebel Med NW Pricing Structure

Seattle Met Magazine Top Doctor Rebel Med NW 2022Rebel Med NW has chosen to structure its-self as a hybrid / concierge practice so that we can continue to sustain our clinic operations as a small business, respectfully pay our providers and support staff, and continue to be here as a comprehensive health resource for our community.

Not every insurance company provides benefits for all services as performed by our providers, as insurance focuses on this disease centric model for healthcare, Rebel Med NW focuses on Primary care with a preventative, mind body, and functional medicine approach to health and wellness that we find saves you the patient both financially and in time, as a true investment in your health and well-being.

Below you will find our transparent price structure so you are aware of what our direct pricing is related to a cost of a service should your insurance plan not provide benefits for a particular service. We will always provide a discount to this direct pricing rate if your insurance denies benefits.

If you have any questions, please reach out to our Billing Team account in the Patient Portal.

Rebel Med NW Concierge Membership

Rebel Med NW is proud to offer a straight forward concierge membership that allows you to mix and match non-covered services that your insurance doesn’t provide benefits for, such as:

Insurance Admin Fee waived
Extended time visits
Same day scheduling
Cancelation fee waived
Vitamin Injection visits
IV Therapy visits
Discount on dietary supplements
Access to our library of Health & Wellness Programs

Rebel Med NW Fee Schedule & Non-Covered Services FAQ / Good Faith Estimate

Administration Fee

Rebel Med NW services that are processed through your private commercial insurance carrier will incur and additional administration fee at every insurance based visit:

Acupuncture visit – $25
Naturopathic Medicine Visits – $25 per 30 min
Physical Medicine / Massage Visits – $25

This Admin fee is waived if using a Rebel Med NW Membership. This administration fee provides you the support services for 1 week post visit including communication with your provider regarding your care.

What does the Administration fee cover?

The admin fee covers the cost our office incurs for billing your private insurance plan, as it has become increasingly more expensive to bill insurance, and the the costs incurred for claim submission, re-submission, billing fees, prior-auth time, and merchant processing fees for payment collection.

Does insurance cover this fee?

No, This fee is to sustain the operational support it takes to be able to even bill insurance in the first place. As a small business primary care facility, we agree that patients want to use their insurance where possible for medically necessary services, but due to insurance reimbursement rates not rising in the last 10 years, we have to pass some of this operational cost on to be able to sustain operations, while still being able to accept some of the insurance based care. Consider the Rebel Med NW Membership for added benefits at our office.

Extended time visits / Comprehensive Lab review Visits

When no extended time benefits covered by your insurance, an extended time charge is applied for every 15 minutes after a 30 minute return visit.

$60 for additional 15 minutes
$100 for additional 30 minutes.
Sliding Scale available for medicaid, HCA Waiver required.
Waived with RMNW Concierge membership.

Office Visits

Office Visits Costs if not covered by insurance: $120-350 based on time/complexity, Superbill available if you submit out of network for reimbursement.

Annual Exams

Annual Exam costs if not covered by insurance: $120-350 based on new vs established and age of patient per standard CPT coding. Superbill available if you submit out of network for reimbursement.

Extended time visits / Comprehensive Lab review Visits

When no extended time benefits covered by your insurance, an extended time charge is applied for every 15 minutes after a 30 minute return visit at $60 for 15 minutes and $100 for additional 30 minutes. Waived with RMNW Concierge membership.

No show Fee or Late cancelation - ND

$125 – The No Show/Late Cancellation fee is applied to cancellations made less than 24 hours in advance or the visit is No-Showed. This is to cover the loss for the provider because we did not have the time to fill the opening with another appointment. First No-show/Late Cancel will be a courtesy reminder and emergency events or illnesses are exempted, but please try to let us know as soon as possible so we can attempt to fill the space with the patients on our waiting List.

Acupuncture Evaluation / Chinese Herbal Medicine Consult

An initial evaluation to one of our Chinese Medicine practitioners, can typically be billed to insurance, however when not covered by insurance for a 99203 or 99204 it will be $50 or $75 respectfully in addition to additional procedures performed.

A follow-up evaluation performed for a new medical concern, or for additional management, education time, or counseling a 99213 or 99214 is used and will be $30 or $50 when no benefits provided by insurance.

Chinese Massage, Tua Na, Cupping Therapies

When your insurance company doesn’t provide benefits for 97140, manual therapy, we charge $25 per 15 minutes of manual therapy time, this can include time spent for Chinese massage, cupping, or body work performed by the practitioner.

Heat Therapies / Infrared / Moxibustion

When your insurance doesn’t provide benefits for the heat applications provided by Chinese medicine practitioners, we charge $5 for this service.

No show Fee or Late cancelation - Acupuncture

$75.00 – The No Show/Late Cancellation fee is applied to cancellations made less than 24 hours in advance or the visit is No-Showed. This is to cover the loss for the provider because we did not have the time to fill the opening with another appointment. First No-show/Late Cancel will be a courtesy reminder and emergency events or illnesses are exempted, but please try to let us know as soon as possible so we can attempt to fill the space with the patients on our waiting List.

Blood Draw Processing Fee

Blood Draw processing fees are as follows:

$20 – Standard blood draw fee for Typical annual or evaluation labs

$50 – Advanced testing panels for Food Allergy, Nutrition / Urine Panels.

Food Allergy Tests

Food Allergy tests are rarely covered by insurance, we have several options available that range from $209-$500. Non-covered Service waiver needed.

Functional Medicine Hormone, Digestive, & Nutrition Panels

We offer multiple options for in person or drop-shipped based nutritional, hormonal, or GI function panels that can provide comprehensive awareness of your health and current physiology. These panels have some variability in insurance coverage as you work with each lab. Due to the complex nature of these panels, we do charge a $100 interpretation fee for the time needed to customize care recommendations for your health, this is covered once per 6 months under the RMNW Concierge Membership.

Biofeedback Training

When not covered by your insurance, a $125 non-covered biofeedback service fee is applied in addition to any patient responsibility through their insurance for the 30 minute office visit portion of their 60 minute biofeedback training session.

Virtual Reality Exposure Therapy w/ Biofeedback

When not covered by your insurance, a $150 non-covered biofeedback service fee is applied in addition to any patient responsibility through their insurance for the 30 minute office visit portion of their 60 minute biofeedback training session.

Extended time Counseling Visits

When not covered by your insurance, an extended time charge is applied for every 15 minutes after a 30 minute return visit at $60 for 15 minutes and $100 for additional 30 minutes of counseling and health coaching support. Sliding scale available for apple health/medicaid clients. Waived with RMNW Concierge membership.

Massage Therapy

Massage therapy provided at Rebel Med NW uses the standard 97124 CPT coding, and when not covered by your insurance, our direct pricing rate for 60 minute scheduled massage is $150/ 60 minutes, $200/ 90 minutes, and $250/ 120 minutes.

No show Fee or Late cancelation - Massage

$100.00 – The No Show/Late Cancellation fee is applied to cancellations made less than 24 hours in advance or the visit is No-Showed. This is to cover the loss for the provider because we did not have the time to fill the opening with another appointment. First No-show/Late Cancel will be a courtesy reminder and emergency events or illnesses are exempted, but please try to let us know as soon as possible so we can attempt to fill the space with the patients on our waiting List.

Iron IV Infusion

We offer Iron IV Infusion, but is rarely covered by insurance for functional medicine benefit, and may only provide partial coverage for material and supply cost. We charge a direct pricing supply charge of $125/100mg for each Iron IV + additional patient responsibility per insurance guidance for copay or deductible for the process of infusion or any associated office visit performed.

Nutrient IV Therapy

This is a direct pricing service as listed on our Nutrient IV Therapy Page per each item listed, and is not a billable service to insurance.

Nutrient IM Injections

This is a direct pricing service as listed on our Nutrient Vitamin Injection Page per each item listed, and is not a billable service to insurance.

Cosmetic Acupuncture & Facial Bio-Injections

This is not a service that is billable to insurance at this time, and the pricing outlined is reviewed prior to having the service performed. We offer various package discounts & financing options through Care Credit if needed.

RF Microneedling with Potenza

This is not a service that is billable to insurance at this time, and the pricing outlined is reviewed prior to having the service performed. We offer various package discounts & financing options through Care Credit if needed.

Naturopathic Medicine

We apply a 50% sliding scale for Low Income / Medicaid services, and a 30% sliding scale for Military / Seniors for services that are considered medically necessary.

Office Visits: $75-$150

Physical medicine procedures: $30-80

Counseling/Biofeedback/VR Exposure therapy procedures: $50-100

Acupuncture

Our initial rate for Acupuncture is discounted by $50 for initial visits, and by $25 for return visits. (Initial $125 & Return $100)

General Statements about Potential benefits provided for various in-network services

Acupuncture

Evaluation Codes*: 99202, 99203, 99213, 99212 are generally covered every 4-6 visits. If denied $30-75 non-covered cost is applied
Core Acupuncture procedure Codes: Benefits are generally provided up to 3 units for combination of 97810, 97811, 97813, 97814
Manual Therapy: 97140, code is used for purposes of bodywork, cupping, chinese massage at 15 minute increments, typically benefits available unless a prior-auth is needed, and may use some of your PT benefits, when denied by insurance, cost is $25.

*Not all conditions may be eligible for acupuncture, and if denied, will be subject to direct pricing, providers are trained to use the most specific code for the condition you are being treated for.

Naturopathic Medicine

Office Visits: Typically benefits available as copay/coinsurance/deductible.
Annual Exams: Typically benefits available if naturopathic benefits available.
Spinal Manipulation: Typically benefits available allotted under your chiropractic listed benefits, may be subject to co-insurance.
Trigger Point Injections: Typically benefits available as after deductible or co-insurance.
Biofeedback: Typically not covered, unless prior auth obtained for Migraine Treatment as only covered benefit, regular Non-covered fee applies for treatments for mental health, cardiovascular, pain management, or digestive health goals.

Acupuncture

Evaluation Codes*: 99202, 99203, 99213, 99212 are generally covered every 4-6 visits. If denied $30-75 non-covered cost is applied
Core Acupuncture procedure Codes: Benefits are generally provided up to 3 units for combination of 97810, 97811, 97813, 97814
Manual Therapy: 97140, code is used for purposes of bodywork, cupping, Chinese massage at 15 minute increments, typically benefits available unless a prior-auth is needed, and may use some of your PT benefits, when denied by insurance, cost is $25.

*Not all conditions may be eligible for acupuncture, and if denied, will be subject to direct pricing, providers are trained to use the most specific code for the condition you are being treated for.

Naturopathic Medicine

Office Visits: Typically benefits available as copay/coinsurance/deductible.
Annual Exams: Typically benefits available if naturopathic benefits available.
Spinal Manipulation: Typically benefits available allotted under your chiropractic listed benefits, may be subject to co-insurance.
Trigger Point Injections: Typically benefits available as after deductible or co-insurance.
Biofeedback: May provide benefits for cardiovascular, migraines, mental health, or digestive health concerns

*Some out of state Premera Blue Cross Plans may not provide Naturopathic Medicine Benefits

Biofeedback & Mind Body Medicine

Premera Biofeedback info

No show Fee or Late cancelation - Acupuncture

Blood Draw Processing Fee

Blood Draw processing fees are as follows:

$20 – Standard blood draw fee for Typical annual or evaluation labs

$50 – Advanced testing panels for Food Allergy, Nutrition / Urine Panels.

Food Allergy Tests

Food Allergy tests are rarely covered by insurance, we have several options available that range from $209-$500. Non-covered Service waiver needed.

Functional Medicine Hormone, Digestive, & Nutrition Panels

We offer multiple options for in person or drop-shipped based nutritional, hormonal, or GI function panels that can provide comprehensive awareness of your health and current physiology. These panels have some variability in insurance coverage as you work with each lab. Due to the complex nature of these panels, we do charge a $100 interpretation fee for the time needed to customize care recommendations for your health, this is covered once per 6 months under the RMNW Concierge Membership.

Massage Therapy

Massage therapy provided at Rebel Med NW uses the standard 97124 CPT coding, and when not covered by your insurance, our direct pricing rate for 60 minute scheduled massage is $150/ 60 minutes, $200/ 90 minutes, and $250/ 120 minutes.

No show Fee or Late cancelation - Massage

$100.00 – The No Show/Late Cancellation fee is applied to cancellations made less than 24 hours in advance or the visit is No-Showed. This is to cover the loss for the provider because we did not have the time to fill the opening with another appointment. First No-show/Late Cancel will be a courtesy reminder and emergency events or illnesses are exempted, but please try to let us know as soon as possible so we can attempt to fill the space with the patients on our waiting List.

Office Visits

Office Visits Costs if not covered by insurance: $120-350 based on time/complexity, Superbill available if you submit out of network for reimbursement.

Annual Exams

Annual Exam costs if not covered by insurance: $120-350 based on new vs established and age of patient per standard CPT coding. Superbill available if you submit out of network for reimbursement.

Extended time visits / Comprehensive Lab review Visits

When no extended time benefits covered by your insurance, an extended time charge is applied for every 15 minutes after a 30 minute return visit at $60 for 15 minutes and $100 for additional 30 minutes. Waived with RMNW Concierge membership.

No show Fee or Late cancelation - ND

$125 – The No Show/Late Cancellation fee is applied to cancellations made less than 24 hours in advance or the visit is No-Showed. This is to cover the loss for the provider because we did not have the time to fill the opening with another appointment. First No-show/Late Cancel will be a courtesy reminder and emergency events or illnesses are exempted, but please try to let us know as soon as possible so we can attempt to fill the space with the patients on our waiting List.

Biofeedback Training

When not covered by your insurance, a $125 non-covered biofeedback service fee is applied in addition to any patient responsibility through their insurance for the 30 minute office visit portion of their 60 minute biofeedback training session.

Virtual Reality Exposure Therapy w/ Biofeedback

When not covered by your insurance, a $150 non-covered biofeedback service fee is applied in addition to any patient responsibility through their insurance for the 30 minute office visit portion of their 60 minute biofeedback training session.

Extended time Counseling Visits

When not covered by your insurance, an extended time charge is applied for every 15 minutes after a 30 minute return visit at $60 for 15 minutes and $100 for additional 30 minutes of counseling and health coaching support. Sliding scale available for apple health/medicaid clients. Waived with RMNW Concierge membership.

Iron IV Infusion

We offer Iron IV Infusion, but is rarely covered by insurance for functional medicine benefit, and may only provide partial coverage for material and supply cost. We charge a direct pricing supply charge of $125/100mg for each Iron IV + additional patient responsibility per insurance guidance for copay or deductible for the process of infusion or any associated office visit performed.

Nutrient IV Therapy

This is a direct pricing service as listed on our Nutrient IV Therapy Page per each item listed, and is not a billable service to insurance.

Nutrient IM Injections

This is a direct pricing service as listed on our Nutrient Vitamin Injection Page per each item listed, and is not a billable service to insurance.

Cosmetic Acupuncture & Facial Bio-Injections

This is not a service that is billable to insurance at this time, and the pricing outlined is reviewed prior to having the service performed. We offer various package discounts & financing options through Care Credit if needed.

RF Microneedling with Potenza

This is not a service that is billable to insurance at this time, and the pricing outlined is reviewed prior to having the service performed. We offer various package discounts & financing options through Care Credit if needed.

Naturopathic Medicine

We apply a 50% sliding scale for Low Income / Medicaid services, and a 30% sliding scale for Military / Seniors for services that are considered medically necessary.

Office Visits: $75-$150

Physical medicine procedures: $30-80

Counseling/Biofeedback/VR Exposure therapy procedures: $50-100

Acupuncture

Our initial rate for Acupuncture is discounted by $50 for initial visits, and by $25 for return visits. (Initial $125 & Return $100)

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