“Good Faith Estimate

for Health Care Items and Services”

Under the No Surprises Act

●   Beginning January 1, 2022, psychologists and other mental health care providers will be required by law to give uninsured and self-pay patients a good faith estimate of costs for services that they offer, when scheduling care or when the patient requests an estimate.

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

●     Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or 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 www.cms.gov/nosurprises or call 800-985-3059.