Good Faith Estimate

You have the right to receive a Good Faith Estimate explaining how much your medical and mental health care will cost.

Your Right to a Good Faith Estimate

Under the federal No Surprises Act, health care providers are required to give clients who do not have insurance, or who are not using insurance, an estimate of the expected charges for medical services, including psychotherapy.

• You have the right to receive a Good Faith Estimate of the expected cost of any non-emergency services, including psychotherapy.
• Make sure your provider gives you a Good Faith Estimate in writing at least one business day before your service. You can also ask for one before you schedule a service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you may dispute the bill.
• Save a copy or picture of your Good Faith Estimate.

How We Provide Your Estimate

At the start of services, you will receive a written Good Faith Estimate that includes the expected per-session fee, the anticipated frequency and duration of services, and any applicable additional fees (such as documentation, court-related work, or late cancellation). Because the duration of therapy depends on your goals and progress, the estimate is based on a typical course of treatment and may be updated as needed.

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.

This page is provided for general informational purposes and does not constitute legal advice. The final Good Faith Estimate notice should be reviewed by an attorney or qualified compliance professional prior to clinical use.