At the Austen Riggs Center, our approach to treatment is tailored to the needs of each individual, and as a result, each patient’s costs vary accordingly. We work on an out-of-network basis with insurance, and many of our patients are able to utilize reimbursements to help finance treatment, in some instances getting full coverage.
Riggs offers a range of treatment programs, and the total length of stay can run from six weeks to a year or more. The median length of treatment is approximately five to six months. Depending on the program, the cost of the six-week evaluation and treatment phase ranges from $75,500 to $81,380*, which includes an admission consultation fee of $2,000. A refundable payment of $50,000 (applied to the cost of treatment) is required on the day of admission. We encourage you to contact our Admissions team for specific information.
As you can read below, most of our patients are able to utilize insurance reimbursements to help finance treatment, in some instances getting full coverage. Generally, the cost of treatment for patients who remain at Riggs for a few months averages $1,200 per day. Patients remaining in treatment for longer periods of time, when clinically indicated, may step down to less costly treatment programs that are less intensively staffed. Our all-inclusive fees cover room and board, individual psychotherapy sessions four times a week**, pharmacotherapy, social work and family work (if indicated), nursing care, fitness classes, access to our Therapeutic Community Program and Activities Program, and more. Download the PDF for details.
* As of 7/1/23; subject to change
** On occasion, due to holidays or therapist absences, interim therapy sessions occur two times/week
Over the past five years, Riggs provided $5 million in financial assistance and payment discounts. The patient and/or financially responsible party may complete a Fee Reduction Application prior to admission or at any time during treatment. After considering all relevant factors, including a review of available financial resources and the patient’s treatment plan, we may provide a fee reduction of up to 35%.
In the event of a sudden change in financial resources, patients may re-apply for a termination phase fee reduction, which may exceed 35% for brief periods. Fee reductions are not retroactive but may be offered from the date of filing of a completed application. Reductions are generally granted only for days not covered by health insurance. Please note: Failure to keep an account current may jeopardize a granted fee reduction.
A prompt-payment discount of three percent is available to those who are not receiving a need-based fee reduction and not paying by credit card, and only when payment is received by the 10th of the month.
For more information or to obtain a Fee Reduction Application, contact patient billing at 413.931.5207 or our Admissions office at 800.517.4447, Monday through Friday, 8:30 a.m. to 5:00 p.m. (Eastern). For answers regarding the application process, please contact Director of Finance Melissa Agosto at 413.931.5286.
The Austen Riggs Center is not an “in-network provider” with any health insurance plans and is not eligible for Medicare or Medicaid reimbursement; Riggs is largely self-pay. However, we work aggressively to help families and patients obtain reimbursement from their insurance plan. As a result, more than 90% of patients with insurance policies offering out-of-network benefits receive coverage to support some of the cost of treatment. On average, these patients are approved for 60-90 days of coverage (60 = median number of days, 90 = mean number of days). Payment is typically based on the insurance companies’ "usual and customary" daily rate.
Your responsibilities: You are your own best advocate, but the Admissions office may help you gather some of the following information:
Know your policy’s benefits and limits, including whether your plan covers out-of-network residential treatment for behavioral health problems
Provide the Admissions office your plan’s criteria for determining medically necessary residential behavioral health treatment; ask your insurance company if preauthorization is required before they will approve admission
Ask your referring clinician to attempt preauthorization shortly before your scheduled admission consultation at Riggs
Manage the insurance appeals process if there have been two insurance denials of preauthorization*
* It is your responsibility to (1) provide your insurance company a written request for an appeal; (2) sign a release for medical records to be sent to your insurance company; and (3) you may opt to request a letter of medical necessity from your therapist.
Our responsibilities: To the best of our ability, we will:
Request preauthorization (within 48 hours) from your insurance company after the initial admission consultation and subsequent admission to Riggs; we cannot request preauthorization if: (1) new insurance becomes effective during ongoing treatment, and/or (2) your policy has no out-of-network residential benefit
Notify you in writing if preauthorization is approved, and participate in ongoing utilization reviews as directed by your insurance company for as long as coverage is authorized during your stay
Conduct a doctor-to-doctor peer review with the insurance company if preauthorization is denied; if this results in a second denial, Riggs will notify you in writing, after which it is your responsibility to pursue any further appeal**
** If requested, we can be of limited assistance in the appeals process, such as by providing supporting documentation or copies of medical records, but we do not track the appeals process and are not notified of its outcome.
Note: Upon request, Riggs will submit claims directly to the insurance company on behalf of you and/or the financially responsible party, but in any event, accounts must be kept current. Insurance payments received by Riggs are credited to your account; if there is a credit balance at discharge, it is returned to the financially responsible party.