Good Faith Estimate

Good Faith Estimate Notice

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

Under the law, health care providers are required to provide an estimate of expected charges for services to clients who are not using insurance.

Your Right to a Good Faith Estimate

  • You have the right to receive a Good Faith Estimate for the total expected cost of services.

  • This includes psychotherapy services and any related services.

  • You may request a Good Faith Estimate before scheduling services or at any time during treatment.

What If Costs Differ?

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.

Questions or Requests

You can ask for a Good Faith Estimate before scheduling services or at any time.

Additional Information

For more information about your rights, visit:

www.cms.gov/nosurprises

This website is for informational purposes only and does not constitute medical or mental health advice. Use of this website does not establish a therapist-client relationship.