Good Faith Estimate
NO SURPRISES ACT: GOOD FAITH ESTIMATE
Under Section 2799B-6 of the Public Health Service Act, out-of-network healthcare providers and healthcare facilities are required to inform individuals upon request or at the time of scheduling healthcare items and services for out-of-network services, a “Good Faith Estimate” of expected charges for the year.
You have the right to receive a “Good Faith Estimate” explaining how much your care could cost over the year.
Under the law, healthcare providers need to give patients who don’t have insurance or who are using out-of-network benefits an estimate of the bill for services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests or office visits.
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.
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Based on a fee of $250 per visit, the following are expected charges of psychotherapy services:
Total estimated charges for 1 session per week
1 Week of Service $250
13 Weeks of Service (Approx. 3 Months) $3250
26 Weeks of Service (Approx. 6 months) $6500
39 Weeks of Service (Approx. 9 months) $9750
52 Weeks of Service (Approx. 12 Months) $13000
Total estimated charges for 2 sessions per week
1 Week of Service $500
13 Weeks of Service (Approx. 3 Months) $6500
26 Weeks of Service (Approx. 6 months) $13000
39 Weeks of Service (Approx. 9 months) $19500
52 Weeks of Service (Approx. 12 Months) $26000
Total estimated charges for 1 session every other week
1 Week of Service $250
13 Weeks of Service (Approx. 3 Months) $1500
26 Weeks of Service (Approx. 6 months) $3000
39 Weeks of Service (Approx. 9 months) $4500
52 Weeks of Service (Approx. 12 Months) $6000
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Based on a fee of $225 per visit, the following are expected charges of psychotherapy services:
Total estimated charges for 1 session per week
1 Week of Service $225
13 Weeks of Service (Approx. 3 Months) $2925
26 Weeks of Service (Approx. 6 months) $5850
39 Weeks of Service (Approx. 9 months) $8775
52 Weeks of Service (Approx. 12 Months) $11700
Total estimated charges for 2 sessions per week
1 Week of Service $450
13 Weeks of Service (Approx. 3 Months) $5850
26 Weeks of Service (Approx. 6 months) $11700
39 Weeks of Service (Approx. 9 months) $17550
52 Weeks of Service (Approx. 12 Months) $23400
Total estimated charges for 1 session every other week
1 Week of Service $225
13 Weeks of Service (Approx. 3 Months) $1350
26 Weeks of Service (Approx. 6 months) $2925
39 Weeks of Service (Approx. 9 months) $4500
52 Weeks of Service (Approx. 12 Months) $5850
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Based on a fee of $325 per visit, the following are expected charges of psychotherapy services:
Total estimated charges for 1 session per week
1 Week of Service $325
13 Weeks of Service (Approx. 3 Months) $4225
26 Weeks of Service (Approx. 6 months) $8450
39 Weeks of Service (Approx. 9 months) $12675
52 Weeks of Service (Approx. 12 Months) $16900
Total estimated charges for 2 sessions per week
1 Week of Service $650
13 Weeks of Service (Approx. 3 Months) $8450
26 Weeks of Service (Approx. 6 months) $16900
39 Weeks of Service (Approx. 9 months) $25350
52 Weeks of Service (Approx. 12 Months) $33800
Total estimated charges for 1 session every other week
1 Week of Service $325
13 Weeks of Service (Approx. 3 Months) $2275
26 Weeks of Service (Approx. 6 months) $4225
39 Weeks of Service (Approx. 9 months) $6500
52 Weeks of Service (Approx. 12 Months) $8450
