Frequently Asked Questions

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Cognitive Behavioral Therapy for Insomnia (CBT-I) is a fairly structured treatment that generally takes about 8 sessions though when the circumstances related to insomnia are complex, it can take longer.  The first 1 to 2 sessions are devoted to completing a thorough assessment of your insomnia and its development along with a careful examination of any medical, psychiatric and behavioral conditions that could be contributing to the problem.  After the assessment process is completed, the remaining sessions are devoted to putting the initial treatment plan into action and making adjustments as needed.  

We will discuss my clinical impressions at any point in our work so that you can make a good decision about treatment.  Regardless of our work together, therapy is never required, it is a choice you make to attend and do the work.  Outside of our meetings, there will be much work for you to complete for treatment to be successful.  

Most of my clients meet with me weekly.  When we meet for our first appointment, we will discuss my recommendations for next steps, including frequency of our work.  As we work together, we may discuss increasing or decreasing how often we meet for treatment.

For Cognitive Behavioral Therapy for Insomnia (CBT-I), I usually suggest meeting once a week for at least the first few sessions.  If you're unable to commit to that, let me know because we might be able to work around it without compromising your treatment.

I've been helping people overcome their insomnia, regain confidence in their sleep, and stop taking sleeping medications for years.  CBT-I is the first-line recommended treatment for insomnia because the research is overwhelmingly in its favor.  I can't promise that it will work for you - I have seen people whose insomnia continues after trying CBT-I, unfortunately.  What I can say is that if you haven't tried CBT-I, you should.  

The most common treatment for insomnia is sleep medication. While these medicines can be  effective particularly at the onset of symptoms, their long term use is generally considered by most sleep experts as a poor strategy. Also, most people who take sleep medications long term at some point begin feel that they want to get back to sleeping on their own, or they find the sleep medication is no longer providing the relief it once did.  

Some sleep medications are useful under the right circumstances.  Fortunately, in the realm of Insomnia, CBT-I is another, and usually better strategy for the long run.  CBT-I is a short-term non-medication treatment that can effectively address your difficulties with sleep.  CBT-I addresses counter-productive conditioning, the worry, problems with daytime function and night-time habits that can prevent you from sleeping that you may not even recognize.  

Yes.  My practice is Behavioral Sleep Medicine (BSM), which includes many other sleep problems - and more than just insomnia.  On the other hand, BSM isn't helpful for every sleep disorder.  I recommend discussing what your sleep concerns  are with me so we can decide whether I am the best person to be treating you.

With your written permission, I will collaborate with your other providers to coordinate care.  I enjoy providing other health professionals with your treatment progress and look forward to helping your other health and mental health professionals connect the dots between your sleep treatment and other treatments you receive. 

Many of my patients are also being seen for psychotherapy and most wish to continue with their current therapist. I will work as an adjunct with you and your treating therapist to provide targeted treatment to improve your sleep. I will work closely with your therapist to make sure that our treatments complement one another.
 

For now, I only see those 18 years and older for treatment.  If you're looking for help with sleep in a child or adolescent, I recommend Jodi Mindell, Ph.D., and her group at the Children's Hospital of Philadelphia. Her department sees all ages, including infants.

By the way, even though I don't treat those under 18, I strongly support efforts to start middle and high school classes at 8:30am or later.  Learn more at Start School Later. I also provide consulting and presentations to school districts: students, parents, faculty and school boards. This area has been a passion of mine for decades.

The fee for the first appointment (90 minutes) is $350.  The fee for subsequent appointments (50 minutes) is $225.

I am not in-network with any insurance companies.  You are responsible for paying your full fee at the time of service.  If you choose to submit claims to your insurance company for reimbursement for any out-of-network benefits you might have, I will provide you with a superbill after each session for this purpose.

Medicare will not reimburse you at all for our work together if you submit claims from our sessions.  If you are are covered by Medicare and planning to see me, you will need to sign a Medicare Private Contract before starting treatment.  This form indicates that you agree to pay my full fee.  

There is no benefit to submitting your claims for our sessions to Medicare unless you have a secondary insurer who needs to see the claim rejected by Medicare before reimbursing you.

You will need to know the specific "procedure code" I use for the sessions we could have.

• In-Person Session Procedure Codes
  • 90834 for a 45-minute in-person session
  • 90791 for the initial 90-minute psychiatric diagnostic evaluation.  This only applies to the first in-person session with new patients
• Video Session Procedure Codes
  • 90834 (95) for a 45-minute video session
  • 90791 (95) for the initial 90-minute psychiatric diagnostic evaluation. This only applies to the first in-person session with new patients
• Phone Session Procedure Code
  • 90899 regardless of session length, so this same code applies for 45 minutes for return patients or 90 minutes for new patients

I also suggest that you ask about your deductible since this might need to be met before you are reimbursement for session fees.

I am available to meet with patients in my Media, PA office on Wednesdays.  I am often available to meet via Telehealth Monday through Friday.  

I'm often unable to answer the phone but I check messages frequently and generally call or email back within 1 business day.

Yes.  Here is what you need to know about telehealth: 

      Telehealth sessions are conducted at a scheduled time, the same as  in-person sessions, but we are physically in two different locations.

     The same length of time as an in-person session.  For a return patient, the session is 50 minutes.

My fees are the same for telehealth as for in-person.  A first appointment (90-minute session) whether in-person, over the phone, or over video is $350.  The fee for subsequent appointments (50-minute session) whether in-person, over the phone, or over video is $225.

I am not in-network with any insurance companies.  You are responsible for paying your full session fee at the time of service.  If you choose to submit claims to your insurance company for reimbursement for any out-of-network benefits you might have,  I will provide you a "superbill" (a bill you can use with any insurance company) after each session. 

Insurance companies may reimburse for phone or video sessions.  In general, insurance companies are likely to provide some reimbursement for video sessions but no reimbursement for phone sessions.  I strongly encourage you to check with your insurance company to determine costs and coverage. 

Note: you do not have to be at my office to obtain the superbill because it can be found on your secure patient portal so you can obtain it virtually.  If you prefer, I  mail you a copy of the superbill).