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Cash Fee Schedule, Insurance Info, Continue Care & Out-of-Network Options, Hardship Program

Please Review InChargeClinic Terms of Service 2026 Pages 10-15 for charges and billing procedures. We require a valid credit or debit card on file to cover cash payments, co-pays and non-covered patient responsibility payments.

We never charge your debit or credit card without notifying you first.

We request you upload your insurance card when you register and may request updates additional visits.. If you have insurance we verify if we are in-network or your insurer accepts out-of-network services with your plan--we accept FL Medicaid, Medicare, most PPO Insurance and are actively credentialing with multiple insurers--however, there are a number of Marketplace and Private insurance plans who frequently change their networks or have outdated info on their sites that may require Pre-Authorization based on your pre-screening and other registration forms.

We notify you if we are in-network or they automatically accept out-of-network providers, and of any co-pay or payment obligation is prior to your visit.

No Surprises!

For Cash Payment & Pre-Payment Network Exception & Continuity of Care Pending Patients

Please review InChargeClinic Terms of Service 2026 for details and consent.

Eligibility Requirements:

#1 Completed and submitted AFFIDAVIT OF PATIENT UNINSURANCE, NON-USE OF BENEFITS & OUT-OF-NETWORK FINANCIAL RESPONSIBILITY (sent following receipt of registration request)

****Email/Message Administrator@InChargeClinic.com the reference number, date & time from you request call for Network Gap Exception and/or Continuity of Care (stay with same provider in new group)

AND

#2 Submit valid Card/Debit Card Information

INCHARGECLINIC GRACE & HARDSHIP CASH FEE SCHEDULE

Pre-Payment Due 24 hours prior to Scheduled Visits

Standard Cash Fee Schedule

$130 New Patient Visit 45-60 min

$95 Follow-Up 30 min plus, multiple issues, Quarterly (90 Day Visit) 1st New MAT Post-induction Visit

$75 Routine MAT Visit -Average less than 12 months in MAT

& CoC Transferring Patients 1st Visit (20-30 min) $65 Brief Stable 1 issue visit (less than 20 min)

Cancellations-the courtesy of a minimum of 24 hours’ notice appreciated.

No-shows, and late cancellations less than 24 hours before your scheduled appointment, or failure to submit requested testing at least 24 hours before the 2nd appointment may be charged in full.

Outstanding balances must be paid before future appointments or prescriptions can be issued.

Your Options if Out of Network

There are 2 options to consider if you are out-of-network, click below to learn details.

#1 Request a Network Gap Exception

#2 Pay & Submit (Pay Upfront, Complete Visit, You Submit Bill, Insurer Pays You Back)

Note: Some plans allow you to use self-pay for non-covered services and/or out-of-network providers. Call you insurance to verify.

Want to Continue Care?

Following Your Provider to a New Practice

Click Here to Learn Your Rights: Continuity of Care & No Surprise Act

Click here for steps to continue your care at your standard lower in-network rate (same co-pay) up to 90 days.

Fee Schedule for Visit only — medication and lab or CLIA waived home test must be purchased or filed with insurance separately by the pharmacy or lab of your choice.

Click Here to Learn More About Income-Based Financial Hardship Program $65 New Patient $45 Follow-up Visits