Good Faith Estimate

Public Health Service Act section 2799B-6, as added by section 112 of division BB of the CAA, requires providers, upon an individual’s scheduling of services, or upon request, to inquire if the individual is enrolled in a health plan or health insurance coverage, and to provide a notification of the good faith estimate (GFE) of the expected charges for furnishing the scheduled service with the expected billing and diagnostic codes for these items and services. If the individual is enrolled in a health plan or coverage (and is seeking to have a claim for the item or service submitted to the plan or coverage), the provider must provide this notification to the individual’s plan or coverage. In the case that the individual is not enrolled in a health plan or coverage or does not seek to have a claim for the item or service submitted to the plan or coverage, the provider must provide this notification to the individual. These provisions apply with respect to plan years (in the individual market, policy years) beginning on or after January 1, 2022.

DISCLAIMER: These estimates may change as the treatment progresses and are not a guarantee of treatment frequency, length or cost. Your signature does not require you to receive psychotherapy services from me.