The Good Faith Estimate for Therapists: No Surprises Act Basics

Who it applies to

The requirement comes from the No Surprises Act, which took effect January 1, 2022, and it applies to mental health providers. It covers clients who are uninsured or self-pay, meaning they don't have insurance or don't plan to use it for your services. It does not apply to clients using federal programs such as Medicare, Medicaid, or TRICARE.

What you have to do

• Tell uninsured and self-pay clients they have the right to a Good Faith Estimate, both verbally and in writing.
• Provide a written estimate when a client schedules services, and within 3 business days when a client asks for one.
• Include the details the rules require, such as expected services and charges, and information about how to dispute a bill.
• Keep copies of the estimates you've issued.

Why it's easy to get wrong

Therapy rarely has a fixed end date, so estimating ongoing services takes some care. The estimate also needs to be reissued when things change, such as a new rate or a change in session frequency. Practices that build the Good Faith Estimate into their intake process avoid scrambling later.