The “No Surprises Act” & Good Faith Estimates

The No Surprises Act was passed in December 2020, under Section 2799B-6 of the Public Health Service Act, with the aim of protecting consumers from receiving unexpected medical bills.

The Good Faith Estimate provision of the No Surprises Act federally mandates that healthcare providers must give clients an estimate of anticipated healthcare items and services, using what is called a “Good Faith Estimate.” This took effect on January 1, 2022.

What is a Good Faith Estimate?

A Good Faith Estimate is an estimate of the total expected costs of non-emergency healthcare items or services.

  • Intends to offer predictability & transparency in how much clients will be charged for healthcare services prior to their appointment.

  • Includes all regularly scheduled appointments (i.e. therapy sessions).

  • Does NOT include no-shows, late cancellations, or other services related to crisis care, which by definition are unexpected and cannot be predicted for the purpose of compiling a Good Faith Estimate in advance.

  • May also include consultations with client collateral contacts, fees related to paperwork requests, and other legal and administrative fees related to client care, when such items are scheduled in advance.

In my practice, I offer Good Faith Estimates that project out 12 months in advance. Essentially, your estimate will give you a reasonable idea what to expect in terms of therapy costs for one whole year, based on my current rates and the frequency of sessions that we mutually agree upon in advance.

What are your rights as a client?

In an effort to support each and every client in knowing their rights as pertains to the No Surprises Act. You can find more details regarding your federal rights and protections against surprise medical bills here and state laws and protections here.

Make sure to save a copy or photo of your Good Faith Estimate.

For questions about the dispute process or for more information about your right to a Good Faith Estimate, please visit www.cms.gov/nosurprises.