GOOD FAITH ESTIMATE (NO SURPRISES ACT)

Effective Date: July 16, 2026

Your Right to a Good Faith Estimate

Under the No Surprises Act, health care providers are required to provide individuals who are not using insurance with a Good Faith Estimate of expected charges for healthcare services.

This estimate is intended to help you understand the anticipated costs of your care before treatment begins.

Who Receives a Good Faith Estimate?

You are entitled to receive a Good Faith Estimate if you:

  • Are paying for services yourself (self-pay), or

  • Are not submitting claims to your insurance company.

What Does the Estimate Include?

Your Good Faith Estimate will include:

  • The expected cost of your initial evaluation

  • The estimated cost of ongoing therapy sessions

  • Any other reasonably anticipated charges related to your treatment

Because every client's treatment needs are unique, the estimate reflects expected services and may change as therapy progresses.

Does the Estimate Guarantee the Final Cost?

No.

The Good Faith Estimate is an estimate—not a contract—and actual services provided may differ based on your clinical needs, treatment goals, scheduling, or changes requested by you.

If Your Bill Is Higher Than Expected

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill through the federal patient-provider dispute resolution process.

Information about this process is available through the U.S. Department of Health and Human Services.

Questions

If you have questions about your Good Faith Estimate, fees, or payment options, please contact me before beginning services.

I believe clients should understand the financial aspects of treatment and am happy to discuss costs with you.