No Surprises Act Disclosure

For psychotherapy services, the No Surprises Act primarily applies to clients who are uninsured or who choose not to use their insurance (self-pay clients). These clients have the right to receive a Good Faith Estimate of expected costs before services begin.

A Good Faith Estimate is a written document that explains the expected cost of your therapy services based on information known at the time it is created. It helps you understand anticipated fees before starting care.

You will receive a Good Faith Estimate:

• When you schedule services at least 3 business days in advance
• Within the required federal timeframes if services are scheduled sooner
• Anytime you request one before starting therapy

You may also request an updated estimate if your treatment plan changes.

No. A Good Faith Estimate is not a contract and does not guarantee final charges. Actual costs may vary depending on factors such as session length, frequency, or changes in your clinical needs.

If you are uninsured or self-pay and receive a bill that is at least $400 more than your Good Faith Estimate, you may be eligible to use a federal patient-provider dispute resolution process. Requests generally must be submitted within 120 days of receiving the bill.

Some protections of the No Surprises Act apply to insured clients, particularly related to emergency services and certain out-of-network situations. However, Good Faith Estimate requirements primarily apply to uninsured or self-pay clients in outpatient psychotherapy settings.

If you initially choose to self-pay and later decide to use insurance, your costs and protections may change based on your insurance plan. You may request an updated Good Faith Estimate at any time.