Good Faith Estimate Under the No Surprises Act

As part of our commitment to transparent and ethical care, you have the right to receive a Good Faith Estimate (GFE) explaining the potential costs of your medical care. This estimate is based on the information known at the time and is not a binding contract.

Your Rights

You’re entitled to a GFE if you don’t have insurance or are not using insurance.
The estimate includes the total expected cost for non-emergency services, including related costs like tests, prescription drugs, and hospital fees.
Request a GFE in writing at least one business day before your service. You can also ask for it before scheduling a service.
Your Costs:

The total cost will depend on the number of therapy sessions, your individual circumstances, and the services provided.
You might be charged more than the GFE if special circumstances or complications arise.

Dispute Resolution

If your bill is at least $400 more than the GFE, you can dispute it.
The dispute process must be initiated within 120 calendar days of the bill date. Contact HHS at 800-368-1019 or visit for a dispute form.
Keep Your Estimate:

Save a copy or picture of your GFE. It’s crucial for addressing any billing discrepancies.


For more information about your right to a GFE or the dispute process, visit or call us at 917-740-7199.