Good Faith Estimate Notice

Under the No Surprises Act, all licensed mental health providers are required to provide a Good Faith Estimate (GFE) of expected therapy costs to individuals who are uninsured or choose not to use their insurance.

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As a client of this practice, you have the right to receive a written estimate of the cost of services before your sessions begin.

Your Good Faith Estimate will include:

• The expected cost per session

• The type of services provided

• An estimate of the total cost of care based on your treatment goals

 

This estimate is not a bill, but a transparent overview of what your care may cost over time. The actual number of sessions may vary depending on your needs and preferences. If the actual charges significantly exceed the estimate (by $400 or more), you have the right to dispute the charges through a formal resolution process.

For more information about your rights under the No Surprises Act, visit:
www.cms.gov/nosurprises

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If you have questions or would like to request a Good Faith Estimate, please don’t hesitate to contact me.