Grow Therapy allows limited financial assistance ("charity care") for clients who truly cannot afford their required out‑of‑pocket costs. This exists to support access to care without violating fraud, abuse, or inducement laws.
This is not a way to advertise free care, attract clients, or waive copays.
This policy establishes the framework under which Grow Therapy Providers may provide limited, compliant financial assistance, known as “Charity Care,” to clients who demonstrate an inability to pay for medically necessary services, in accordance with applicable federal and state laws.
When charity care may be appropriate
You may consider charity care only when all of the following are true:
The client expresses financial hardship.
Examples: job loss, disability, major medical bills, unexpected life events.
Household income is estimated at or below 300% of the Federal Poverty Level (FPL).
Income can be self‑reported verbally.
You are not required to collect tax returns or pay stubs.
The client is cash-pay only.
The client is NOT covered by a federal health program or any insurance plan.
This includes Medicare, Medicaid, TRICARE, and VA.
These clients are generally not eligible for charity care.
Documentation: The Grow Therapy provider completes a Provider Financial Hardship Assessment that includes:
The client’s self-reported income and household size;
A description of hardship circumstances (e.g., job loss, disability, out-of-pocket medical debt);
A recommended discount level based on the FPL table below.
Providers can use their own form, but they must produce it to Grow if requested. An example financial assistance form is attached at the end of this article.
What charity care can cover
Charity care applies only to cash pay clients.
It does not change:
Clinical care decisions
Session length or frequency
Billing codes or diagnoses
How long does charity care last?
Approved charity care is valid for up to 1 year
It may end sooner if the client’s financial situation changes
Re‑assessment is required after expiration
Determination & discounts
Discounts should be applied based on the client’s estimated household income as a percentage of the Federal Poverty Level (FPL). This guide is a reference.
0% – 100% | 100% (Full waiver) |
101% – 200% | 75% discount |
201% – 300% | 50% discount |
>300% | Not eligible |
Your responsibilities as a provider
You are responsible for:
Having a good‑faith conversation about financial hardship
Documenting the financial hardship with your own form or sample form (provided below) and uploading it to the client account or saving it for future review.
Avoiding any prohibited conduct (see below)
You are responsible for adjusting the invoice based on your agreement with the patient. Your hardship documentation must be available to produce, if requested.What NOT to do (common pitfalls)
What NOT to do (common pitfalls)
❌ Do not advertise or promise free care
❌ Do not waive copays
❌ Do not decide discounts on your own
❌ Do not offer charity care to influence client choice
❌ Do not apply charity care to federal program clients
How to adjust an invoice for a qualifying cash client
Adjusting an invoice for a qualifying charity case client will occur during the standard invoicing process, after you have completed your documentation. To reduce your cash fee:
Navigate to Appointments in your provider portal and toggle to List view
Select the Unsubmitted tab and locate the desired client's appointment.
Select the Submit Invoice option on the appointment.
Fill in and confirm the session notes and select Submit.
Fill in and confirm the invoice details, ensuring you update the default value in the 'Self-pay visit price' field by using the arrows to the desired amount for this particular client before selecting the Submit button in the top right.
Appendix (Key terms)
Before offering a client a reduced or waived fee, ensure you understand the relevant key terms used to assess their eligibility.
Charity Care / Financial Assistance: A partial or full reduction in client cost-sharing (copay, coinsurance, deductible) granted based on documented financial hardship.
Federal Poverty Level (FPL): Income thresholds issued annually by the U.S. Department of Health and Human Services used to determine eligibility for financial programs.
Medically Necessary Services: Behavioral health services provided by a Grow-affiliated provider that are clinically indicated and covered under typical benefit plans.
Provider Financial Hardship Assessment: A structured note or form completed by the provider and stored in the client's chart documenting the client’s individual expressed financial need, basis for assessment, and requested discount level.