Good Faith Estimate

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Good Faith Estimate Notice


You have the right to receive a “Good Faith Estimate” explaining how much your medical and ​mental health care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are ​not using insurance an estimate of the expected charges for medical services, including ​psychotherapy services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-​emergency healthcare services, including psychotherapy services.

You can ask your health care provider, and any other provider you choose, 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.


For questions or more information about your right to a Good Faith Estimate, visit ​www.cms.gov/nosurprises or call (800) 985-3059.