Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining the cost of your health care.

Under the No Surprise Act, healthcare providers must now provide patients without insurance or who self-pay for their services with an estimate of the bill for healthcare items and services (including psychotherapy services).

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services, including psychotherapy services.

Ensure your healthcare provider provides a Good Faith Estimate in writing at least one business day before your services begin. You can also ask your clinician and any other provider you choose for a Good Faith Estimate before you schedule an item or service.

If you receive a bill for at least $400 more than your Good Faith Estimate, you can dispute it.

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 or call the U.S. Department of Health and Human Services (HHS) at 1-800-985-3059.