good faith estimate
Your Right to Receive a “Good Faith Estimate”
Under the No Surprises Act, health care providers are required to provide patients who are uninsured or who are not using insurance with a Good Faith Estimate of expected charges for medical and mental health services.
You have the right to receive a Good Faith Estimate explaining the anticipated cost of your mental health care before you begin services.
What Is Included in a Good Faith Estimate?
Your Good Faith Estimate may include the expected costs of services reasonably related to your treatment, including:
Initial intake or diagnostic evaluation
Individual psychotherapy sessions conducted via telehealth
Family or couples therapy sessions conducted via telehealth (if offered)
Clinical letters, forms or documentation requests
Late cancellation or no-show fees, when applicable
Example Fee Schedule
Service Estimated Cost
Initial Intake Session (53 minutes) $280
Individual Therapy Session (53 minutes) $280
Couples/Family Therapy Session (53 minutes) $320
Documentation/Letter Requests $50
Late Cancellation / No-Show Fee $280
Consultation (15 minutes) $0
Actual costs may vary depending on your individual treatment needs, session frequency and length of care.
Important Information
A Good Faith Estimate is not a contract and does not obligate you to begin treatment.
Your estimate may be updated if your treatment needs or recommended services change.
Telehealth services are provided only to clients physically located in states where the clinician is authorized to practice at the time of service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.
If you have questions or would like to request a Good Faith Estimate before scheduling services, please contact the practice through the contact page.
Learn More
For more information about your right to receive a Good Faith Estimate, visit: