Page 47 - Appendices for Eric Hartman
P. 47

MENTAL HEALTH SERVICES





       Outpatient group therapy               $40 copay                              Limits apply
       with a psychiatrist





       Outpatient individual                  $40 copay                              Limits apply

       therapy with a psychiatrist





       Outpatient group therapy               $40 copay                              Limits apply
       visit






       Outpatient individual                  $40 copay                              Limits apply
       therapy visit




   OPIOID TREATMENT PROGRAM SERVICES





       Opioid treatment program               In-network: $40 copay                  Limits apply
       services
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