Good Faith Estimate: No Surprises Act (NSA)

What is the No Surprises Act?

Effective January 1, 2022, the No Surprises Act (NSA), which Congress passed as part of the Consolidated Appropriations Act of 2021, is designed to protect clients from surprise medical bills under certain circumstances.

How does the No Surprises Act affect Mental Health Care Providers?

Mental Health Care Providers are now required by law to give uninsured and self-pay clients a Good Faith Estimate of costs for services that they offer.

If you are Billed for more than this Good Faith Estimate, You have the Right to Dispute the Bill

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises/consumers  or call 1-800-985-3059.

Disclaimer

This Good Faith Estimate shows the costs of services that are reasonably expected for your mental health care needs for a service. The estimate is based on information known at the time this Good Faith Estimate was created.

The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.