Good Faith Estimate

An identical GFE is located on the Insurance and Fees page.

If you plan to pay for therapy through the sliding scale, or out of pocket, here’s some important information.

We will provide you with a Good Faith Estimate with specific fees once we schedule you for an intake appointment, within one to three days of scheduling your appointment, depending on how far out your appointment is scheduled.

The Good Faith Estimate is provided on a yearly basis to anyone that is (a) uninsured, or (b) choosing to pay for services out of pocket (the law in question refers to this option as "self-pay"). In these situations, Section 2799B-6 of the Public Health Service Act requires that you receive a good faith estimate of your expected charges with the Practice. This estimate is not a contract and does not require you to work with us.

We will provide you with the cost of services with us that are reasonably expected for your health care needs, through the end of the year. The estimate is based on information known at the time the estimate was created. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment, like if you request, or we recommend, more frequent sessions at a later time. You could be charged more if complications or special circumstances occur. Federal law allows you to dispute (appeal) your bill.

Please let the Practice know if we charge you more than the Good Faith Estimate we provide. You can ask us to (a) modify your costs to match the Good Faith Estimate, (b) negotiate your costs, or (c) or ask us about financial assistance, e.g. paying through the sliding scale.

If you are billed $400 or more over your Good Faith Estimate, you can also dispute the charges by starting a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will pay no more than the price on the Good Faith Estimate. If the agency agrees with the Practice, you will have to pay the higher amount.

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call HHS at 1-877-696-6775.