Beginning January, 2022, The No Surprises Act (HR 133) went into effect. This requires health care providers (including mental health therapists) to provide clients with a Good Faith Estimate (GFE), based upon information known at the time it is issued, that details the cost of expected services.
The intention of this regulation is to prevent people from receiving “surprise” or unanticipated medical bills for treatment. It also provides an estimate of costs for uninsured individual prior to participating in therapy.
Marriage and Family therapists have long had informing clients of the fee prior to beginning therapy a part of their intake procedure and ethical standards. I continue to value transparency regarding fees. Please know there are limitations to this requirement. The GFE does not include unforeseen costs that might arise, such as variable frequency of sessions due to a crisis or reduction in sessions due to illness or time away from the office for either client or therapist. There are factors that make it difficult to determine the exact length of treatment such as therapy goals, variable rate of progress with goals, complexities of treatment or clinical issues, etc.
In my therapy practice, length and frequency of treatment is always negotiated and agreed upon between client and therapist as we work together. Despite a GFR and timelines being discussed, the client can end therapy at any time as well.
The No Surprises Act also states that clients can dispute a bill that is at least $400 more than your GFE. To learn more about this or get a form for the process, go to www.cms.gov/nosurprise.
A Good Faith Estimate is available verbally or in writing prior to our first session and can be included in the patient portal. Please print a copy or take a picture of your GFE for your records if you wish.
Good Faith Estimate Example for Individual Clients
Individual (55-60 minutes) = $185 per session
Couples Session (55-60 minutes) = $185 per session
All other sessions prorated based upon $185 per hour
Weekly Sessions for 48 weeks = $8880
Bi-Weekly Sessions for 48 weeks = $4440