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Good Faith Estimates

Good Faith Estimate LawAs of January 1, 2022, Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to submit a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges. Note: The PHSA and the GFE do not currently apply to any clients using insurance benefits, including Out of Network Benefits (seeking reimbursement from your insurance companies).​


What does this mean? This means that I will be providing a breakdown below of services that I expect us to complete together. While it is not entirely clear or possible for a psychotherapist to know, in advance, how many psychotherapy sessions may be necessary or appropriate for a given person, this form provides an estimate of the cost of services provided. Your total cost of services will depend upon the number of psychotherapy sessions you attend, your circumstances, and the type and amount of services provided to you. This estimate is not a contract and does not obligate you to obtain any services from me, the provider, nor does it include any services rendered to you that are not identified here (i.e., being subpoenaed, crisis/emergency services).


The Good Faith Estimate is not intended to serve as a recommendation for treatment or a prediction that you may need to attend a specific amount of psychotherapy visits. The number of appropriate visits and the estimated costs depends on your needs and what you agree with. You are entitled to disagree with any recommendation made to you concerning your treatment and you may discontinue treatment at any time. If our treatment plan needs to be modified at any time, you will receive an updated Good Faith Estimate. I am committed to working with you based upon your individualized treatment and needs. This will include weekly, bi-weekly, monthly, and/or annually, based upon your needs.

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