Good Faith Estimate*

Under the Federal No Surprises Act (H.R. 133 – effective January 1, 2022), you have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

Note: A Good Faith Estimate is for your awareness only. It does NOT involve you needing to make any type of commitment to the length or frequency of therapy sessions.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

• The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur.

• 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.

*Disclaimer: This legislation is still being interpreted involving mental health professionals and the above statement is in effort to provide what is currently believed to be important and required to share with both prospective and current clients. This page may be updated as more information evolves involving this new statute.