Right to Receive a Good Faith Estimate
Under the No Surprises Act · Effective date: August 4, 2026
You have the right to receive a Good Faith Estimate explaining how much your therapy services will cost if you do not have insurance, or if you are not planning to use insurance to pay for services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services, including related fees for the intake assessment and ongoing sessions, before you schedule a service, or at any time you request it.
- If you schedule a service at least 3 business days in advance, your provider must give you a Good Faith Estimate in writing within 1 business day after scheduling.
- If you schedule a service at least 10 business days in advance, your provider must give you a Good Faith Estimate in writing within 3 business days after scheduling.
- You can also ask any health care provider 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.
How to Request Your Estimate
Current private-pay rates are listed on the Ways to Work Together section of this site. To request a written, personalized Good Faith Estimate before your first appointment, use the inquiry form and select "Therapy Inquiry," or mention it directly in your message.
Questions or Disputes
For more information about your right to a Good Faith Estimate, or how to dispute a bill, visit www.cms.gov/nosurprises or call 1-800-985-3059.
This notice reflects the federally required consumer disclosure under the No Surprises Act. It has not yet been finalized with practice-specific billing procedures or reviewed by a healthcare compliance professional. Insert the effective date, confirm current rates match the Rates section, and have it reviewed before publishing.