Good Faith Estimate

“No Surprises” Act
Effective January 1, 2022, laws regulating client care have been updated to include the “No Surprises” act, which requires a wide variety of providers to give current and potential future clients a “Good Faith Estimate” (GFE) on the cost of treatment. Below you will find a summary of this requirement.

Effective January 1, 2022, a provider must furnish a self-pay patient with the notice and GFE prior to all scheduled services or by request if the patient is shopping for care (and not yet at the point of scheduling). This includes, but is not limited to, office visits, therapy, diagnostic tests, infusions, and surgeries.

Who qualifies as a self-pay patient?
A providerʼs duty to provide notice and a GFE applies to self-pay patients, i.e., an individual who (1) does not have benefits for an item or service under a group health plan, group or individual health insurance coverage offered by a health insurance issuer, federal healthcare program, or a health benefits plan; or (2) chooses not to use his or her coverage benefit for the item or service.

In many ways, this protects patients from discovering that they owe a massive medical bill for un-covered services after the fact. However, therapy is a little different in that we canʼt necessarily provide an estimate of how long it takes to complete a treatment plan. There are a number of variables that make it nearly impossible to quantify what will be needed. And there is no way to give a “good faith estimate” on whether or not a client will want to return for services later on.

Good Faith Estimate Details:
New clients are required to begin with 1 hour intake appointment. Future appointments are scheduled on an as needed basis depending on client preference (i.e. weekly, biweekly, monthly). There is a sliding scale for qualifying clients as well - currently all self-pay clients are on a sliding scale. This is subject to change with notice.

Individual Client:
Intake appointment $140
Follow up (45 min) sessions $140
Client sees therapist weekly for 50 weeks in calendar year $7000
Client sees therapist every other week for 50 weeks $3500
Client sees therapist every 4 weeks for 50 weeks $1680

Couple/Family clients:
Intake appointment $150
Follow up (45 min) sessions $150
Clients see therapist every week for 50 weeks $7500
Clients see therapist every other week for 50 weeks $3750
Clients see therapist every week for 50 weeks $1800

The frequency with which clients are seen, and the duration of time in which they are seen, is dependent on client need. These figures are providing a good faith estimate based on typical scheduling requests. The above examples are for illustrative purposes only and are not specific to you or your treatment. Instead they are meant to show the possible variation of cost that could occur within a given year.