YOUR RIGHT TO RECEIVE A GOOD FAITH ESTIMATE

Under federal law, individuals who do not have health insurance or who are not using health insurance to pay for services have the right to receive a Good Faith Estimate of expected charges for their care.

You have the right to receive a Good Faith Estimate for the expected cost of psychotherapy services before receiving those services.

If you schedule services:

• 3–9 business days in advance: you should receive a written Good Faith Estimate within 1 business day after scheduling.

• 10 or more business days in advance: you should receive a written Good Faith Estimate within 3 business days after scheduling.

You may also request a Good Faith Estimate before scheduling services. If you do, you should receive the estimate in writing within 3 business days of your request.

If a bill from a provider is at least $400 more than the Good Faith Estimate from that provider, you may be eligible to dispute the bill through the federal patient-provider dispute resolution process.

Keep a copy of your Good Faith Estimate for your records.

For questions or more information about your right to a Good Faith Estimate or the federal dispute process, visit the Centers for Medicare & Medicaid Services No Surprises website or call the No Surprises Help Desk at 1-800-985-3059.

Updated: August 2026