Good Faith Estimate Notice

This notice applies to clients who plan to pay for counseling out-of-pocket, meaning that they will not be using insurance benefits.

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

• Under the No Surprises Act, health care providers need to give patients who are not using insurance to pay for services an estimate of the expected charges for medical services, including psychotherapy services. 

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare service, including psychotherapy treatment.

• 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.

• For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.