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| History Intake Appointment |
#99205-21 |
$250.00 |
| Concentration Scan |
#78607 @ $600
#76377 @ $200
#A9512 @ $400
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$1200.00 |
| Resting Scan |
#78607 @ $600
#76377 @ $200
#A9512 @ $400
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$1200.00 |
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Spect Scan Review with Dr. Klindt
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#99215-21 |
$300.00 |
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Fees are payable by VISA, MasterCard, American Express, Cash or Cashier's Checks only (No checks accepted). The full fee is due on the date of the first appointment. It is not the policy of Silicon Valley Brain Imaging, Inc. to bill insurance companies for their patients. A "Superbill" will be issued at the time of the fourth (Review) appointment for the patient's records and for submitting to insurance companies, if needed for reimbursement claims. The patient and/or parent is responsible for all charges incurred whether or not they are covered by insurance.
Fees are payable by VISA, MasterCard, American Express, Cash or Cashier's Checks only (No checks accepted). The full fee is due on the date of the first appointment. It is not the policy of Silicon Valley Brain Imaging, Inc. to bill insurance companies for their patients. A "Superbill" will be issued at the time of the fourth (Review) appointment for the patient's records and for submitting to insurance companies, if needed for reimbursement claims. The patient and/or parent is responsible for all charges incurred whether or not they are covered by insurance.
A 24 hour notice is required to cancel a Scan appointment without charge (call during regular office hours Monday Friday 9am - 6pm). For example, if you need to cancel a Monday Scan appointment please call by Friday morning to avoid charges. Failed or canceled Scan appointments with less than 24 hours notice will be charged a $600.00 fee to partially cover the cost of the procedure materials. History appointments and Review sessions that are failed or canceled with less than 24 hours notice will be charged in full. If for some reason the patient arrives for the scan but will not cooperate with the technician regarding getting an injection (i.e refuses injection)and the scan is unable to be performed there will be a $750.00 fee at that time to partially cover the cost of the time reserved and the procedure materials purchased specifically for the patient. Please schedule your appointments (especially for children) with these policies in mind.
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