Good Faith Estimate

Individuals are entitled to receive a “Good Faith Estimate” of the charges for psychotherapy services. While it is impossible for a psychotherapist to know how many psychotherapy sessions may be necessary or appropriate for a given person, the Good Faith Estimate form estimates the cost of services. 

The total cost of services will depend upon the number of psychotherapy sessions you attend, your circumstances, and the type and amount of services provided to you. The Good Faith Estimate is not a contract and does not obligate you to obtain any services from Dr. Erica Wade, nor does it include any services rendered to you that are not identified here.

This Good Faith Estimate is not intended to serve as a recommendation for treatment or a prediction that you may need to attend a specified number of psychotherapy visits. The number of appropriate visits in your case, and the estimated cost for those services, depends on your needs and what you agree to in consultation with your therapist. You are entitled to disagree with any recommendations concerning your treatment and may discontinue treatment at any time.

The fee for a 60-minute individual psychotherapy visit (in-person or via telehealth) is $_190__ (click Get Started to view additional rates and insurance details). Most clients will attend one psychotherapy visit per week. The frequency of psychotherapy visits that are appropriate in your case may be more or less than once per week, depending upon your needs. If you attend therapy for a longer period, your total estimated charges will increase according to the number of visits and length of treatment.

You have a right to initiate a dispute resolution process if the actual amount charged to you substantially exceeds the estimated charges stated in your Good Faith Estimate (which means $400 or more beyond the estimated charges).

You are encouraged to speak with your provider anytime about any questions regarding your treatment plan or the information provided in a Good Faith Estimate form.  Also, you can ask your provider to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.

If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about four months) of the date on the original bill.

There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees, you will have to pay the prices on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider, you will have to pay a higher amount.

To learn more and get a form to start the process, go to www.cms.gov/nosurprises.