Good Faith Estimate

Right to Receive a Good Faith Estimate

You have the right to receive a Good Faith Estimate explaining how much your mental health care will cost.

Under the law, health care providers need to give uninsured or self-pay patients an estimate of the expected charges for psychotherapy and other services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

• 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 CMS No Surprises or call 1-800-985-3059.