Good Faith Estimate

Your rights under the No Surprises Act

You have the right to receive a “Good Faith Estimate” explaining how much your care will cost.

Under the law, health care providers need to give clients who don't have insurance, or who are not using insurance, an estimate of the expected charges for medical services, including psychotherapy services.

What this means for you

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services, including psychotherapy.
• You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

How this practice provides it

This is a private-pay practice. Fees are discussed during our initial phone consultation, and every client receives a written Good Faith Estimate before beginning treatment. Because the length of psychotherapy varies from person to person, the estimate reflects expected services over a defined period and can be updated as your care continues.

If you would like a Good Faith Estimate before scheduling, you are welcome to request one at any time.

Questions or disputes

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

To request a Good Faith Estimate from this practice, please use the contact form.