Good Faith Estimate

No Surprises Act

You have the right to receive a Good Faith Estimate outlining the cost of your medical and mental health care. In line with Section 2799B-6 of the Public Health Service Act, health care providers and facilities are required to inform individuals—who are not enrolled in an insurance plan or Federal health care program, or who are not planning to file a claim—of their right to request a Good Faith Estimate for any health care services.

This law ensures that if you’re not using insurance, you receive an estimate of the expected charges for services like psychotherapy. Keep in mind, you may save money by choosing an in-network provider.

You have the right to a Good Faith Estimate for the total expected cost of non-emergency services, including related costs such as medical tests, prescriptions, equipment, and hospital fees. Be sure to receive your Good Faith Estimate in writing at least 1 business day before your service. You can always ask for an estimate before scheduling any services.

If you receive a bill that is more than $400 higher than your Good Faith Estimate, you have the right to dispute the bill.

Keep a copy of your Good Faith Estimate for your records. For more information about your rights or questions about the Good Faith Estimate, visit www.cms.gov/nosurprises or call (800) 368-1019.