Good Faith Estimate

In compliance with the recent rollout of the No Surprises Act, a Good Faith Estimate is provided below. This estimate details the cost of one year of sessions with me, at a frequency of once weekly, and is meant to keep clients informed of the potential total cost of services.

Obviously, depending upon frequency of sessions, the estimated total payment may be more or less than what is detailed below. The information below is meant to serve as a guideline for potential clients seeking regular therapy services.

SERVICE PROVIDED:

53 minute psychotherapy session (CPT 90837)

QTY:

48

PRICE PER SESSION:

$170.00

TOTAL PRICE:

$8160.00 based on 12 months of treatment at 1x/week for 48 weeks, with holidays/vacations taken. This estimate does not include unexpected fees such as: paperwork fees, cancellation fees, no-show fees, and consultation fees. 

This Good Faith Estimate shows the cost of services that are reasonable expected for your health care needs for a service. This estimate is based on information known at the time the estimate was created. The estimate does not include any unknown or unexpected costs that may arise during treatment, such as no-show fees, late cancel fees, and emergency sessions. In no way does this estimate hold you to a set number of sessions. You may opt out of treatment at any time. 

Separate good faith estimates will be issued to you upon request. If there is an update to the charges for services, I will provide you with 30 days notice of the change of fee and provide options regarding continuing, transferring, or discontinuing services.

Although the information provided in the GFE is only an estimate, and the actual items, services, or charges may differ from what is included in it, individuals may challenge a bill from a provider through a new patient-provider dispute resolution (PPDR) process if the billed charges substantially exceed the expected charges in the GFE. “Substantially exceeds” means an amount that is at least $400 more than the expected charges listed on the GFE (above).