Good Faith Estimate

Under federal law, individuals who are not using insurance to pay for healthcare services have the right to receive a Good Faith Estimate (GFE) of expected charges.

Because the number and frequency of psychotherapy sessions varies from person to person, it is not possible to determine in advance exactly how many sessions may be appropriate. Your individualized Good Faith Estimate will be provided by your therapist and will be based on the services anticipated at the time of the estimate.

Your estimate will include information such as:

• The provider's name and contact information

• The type of services anticipated

• The estimated fee. (see current fee here)

• The expected frequency or duration of services, when appropriate

• The estimated total cost based on the information available at the time

Please note: A Good Faith Estimate is an estimate, not a contract or a guarantee of the number of services you will receive. Additional services may be recommended or requested separately and may not be included in the estimate.

The actual cost of your care may vary depending on the services you receive, the frequency of appointments, changes in your treatment needs, and the length of treatment.

Your Right to Dispute an Estimate

You have the right to request a review of your charges if the amount you are billed is substantially higher than the estimated charges stated in your Good Faith Estimate (generally $400 or more above the estimate).

For more information about Good Faith Estimates and the patient-provider dispute resolution process, visit CMS No Surprises Act Information or call 1-800-985-3059.

A dispute regarding a Good Faith Estimate will not adversely affect the quality of the services provided to you.

Your therapist can answer questions about your individualized Good Faith Estimate and discuss your treatment plan and anticipated costs with you.