Pre-surgical bariatric evaluation
The behavioral-health evaluation most bariatric programs require before gastric sleeve, bypass, or duodenal switch. One 60-90 minute telehealth session, plus a written report for your surgeon within 3-5 business days. $450 self-pay.
Florida telehealth statewide · Dr. Sasha R. Sioni, DBH, MPH, LMHC-QS.
Why most programs require this
Bariatric surgery permanently changes how you eat and relate to food. The evaluation looks at whether you have the support, coping skills, and psychiatric stability to handle that change well. Most candidates are cleared.
It is not meant to keep you from surgery. It is meant to catch anything that could get in the way of a good outcome, so your team can plan for it.
Who this is for
- Anyone preparing for gastric sleeve, bypass, or duodenal switch
- Patients whose surgeon or insurance requires a behavioral-health evaluation before surgery
- People who want to understand how eating patterns, stress, and emotions might affect their recovery
Before you book: questions for your surgical program
- Do you accept this evaluation from a licensed mental health counselor (LMHC)?
- Do you need specific questionnaires or tests in the report?
- Where should the report go, and is there a deadline?
- Does my insurance plan have its own rules about who does this evaluation?
If your program requires a different type of evaluator, this evaluation will not fit.
Policy check: September 2026. Plans set their own rules, and the rules change. Aetna's obesity surgery policy (Clinical Policy Bulletin 0157 (opens in a new tab), last reviewed July 21, 2026) says members "must be assessed by a qualified behavioral health clinician." Its background section adds that candidates with a history of severe psychiatric illness, candidates under a psychologist's or psychiatrist's care, and candidates who take psychotropic medications "should undergo a comprehensive evaluation by a licensed psychologist or psychiatrist." Cigna's bariatric surgery policy (Medical Coverage Policy 0051 (opens in a new tab), effective July 15, 2026) calls for "unequivocal clearance for bariatric surgery by a mental health provider." UnitedHealthcare's commercial bariatric surgery policy (2026T0362RR (opens in a new tab), effective May 1, 2026) describes an evaluation done "by an individual, who is professionally recognized as part of a behavioral health discipline." Your plan and your surgical program may have other rules, so ask them too.
How it works
- Questionnaires before the session. Your medical history, weight history, and eating patterns, plus short screening questionnaires on mood, anxiety, eating behaviors, and substance use history. You complete them online at your own pace in about 30 to 45 minutes.
- Video evaluation. 60 to 90 minutes. I ask about your readiness for surgery, your psychiatric history, how you cope, who supports you, and what you understand about life after the procedure.
- Report to your surgeon. Within 3 to 5 business days, a clinical summary with a clearance recommendation goes to your surgical team, with your signed authorization. A short feedback session is available if you want one.
Fee
$450 flat, self-pay price. Includes the evaluation, written report to your surgeon, and a feedback session if desired.
If you have Original Medicare or a plan I am in network with, please ask before you schedule, because some parts may need to be billed to your plan. You can often use HSA or FSA funds for parts you pay yourself. If I am not in network with your plan, I can give you a superbill to send to your plan. If you have no insurance or choose not to use your private insurance, you get a written Good Faith Estimate for any part you pay for yourself. If you have Medicare, I tell you in writing before you schedule which parts Medicare covers and what any other part will cost. Evaluation appointments follow the same cancellation policy as therapy: cancel at least 48 hours ahead to avoid the $75 late-cancellation or no-show fee. No deposit is required. Insurance and Medicare do not pay this fee. Some plans do not allow this fee. If yours does not, it is not charged.
Some insurers require a psychiatrist or licensed clinical psychologist. Check your plan and your surgical program's requirements before scheduling, using the questions above.
Evaluator background
Dr. Sasha R. Sioni, DBH, MPH, LMHC-QS. Doctor of Behavioral Health (Arizona State University), Master of Public Health (Yale School of Public Health), Professional Program in Neuropsychological Assessment (UC Berkeley Extension, continuing education). Florida Licensed Mental Health Counselor (MH24469) and Qualified Supervisor.
The Florida LMHC license covers clinical assessment and diagnostic evaluation. The UC Berkeley program is continuing education, not a license. Services are provided as an LMHC and are not neuropsychological testing.
Practical details
- Format: telehealth, Florida statewide
- Total time: 2 to 4 hours including pre-session questionnaires
- Report delivery: 3 to 5 business days from the session
This is an evaluation, not ongoing therapy. Your report goes to your surgical team only with your signed authorization. Before the evaluation begins, you receive full informed consent, including the limits of confidentiality. If your surgical team recommends follow-up counseling, individual therapy is available separately.
For surgical programs
With the patient's signed authorization, a clinical summary with a clearance recommendation goes to your surgical team within 3 to 5 business days of the evaluation session. See how to refer.
Common questions
Will this clear me for surgery?
Most people who have this evaluation are cleared, though some are asked to finish a step first. The evaluation is not meant to block surgery. Its purpose is to find anything that might get in the way of a good outcome, so your surgical team can plan for it. If a concern comes up, I name it clearly and suggest what would address it, rather than putting you on an open-ended hold. Often that is a focused course of therapy, a psychiatric consult, or coordination with your dietitian.
Does my insurance accept your evaluation?
Some insurers and surgical programs require a psychiatrist or a licensed clinical psychologist for this evaluation. Others accept an evaluation from a licensed mental health professional, such as an LMHC. Check with your insurer and surgical program before scheduling. The $450 fee is a self-pay price. If you have Original Medicare or a plan I am in network with, please ask before you schedule, because some parts may need to be billed to your plan. If I am not in network with your plan, I can give you a superbill to send to your plan.
How quickly can my surgeon receive the report?
The report is usually ready 3-5 business days after the evaluation session. If your surgery date is close, mention it at intake and we will plan for it. With your signed authorization, the report goes straight to your surgical team.
What if I am not cleared?
I explain exactly what came up and what would address it. That may be a short course of focused therapy, a psychiatric consult, or coordination with your nutrition or medical team. Once the recommended step is in place, we can revisit the evaluation. The goal is to support a good surgical outcome, not to stand in your way.
Is the evaluation telehealth or in person?
Telehealth, statewide, for clients located in Florida at the time of the session. The evaluation takes 60-90 minutes by secure video. You complete the questionnaires online beforehand.