Good Faith Estimate
The Mindful Counseling Center can offer requesting self-pay clients (current or future) with a “good faith estimate” of the expected total charges for psychotherapy with one of our therapists. Please continue to read for an explanation.
Providing a good faith estimate upon request to self-pay clients who are not using/planning to use health insurance to cover psychotherapy costs is required under the No Surprises Act that went into effect in 2022 (as written into Section 2799B-6 of the Public Health Service Act). Good faith estimates don’t apply to clients using health insurance benefits to pay for these costs.
For the purposes of the Mindful Counseling Center, a good faith estimate of the costs for psychotherapy services for a particular client is calculated by estimating the agreed-upon fee for a psychotherapy session for that client, at a specific frequency (e.g., 1x a week), over a specific number of weeks/months (e.g., 52 weeks/12 months).
Services of the Mindful Counseling Center (NPI: 1164832192 Tax ID: 814754153)
| Service Description | CPT Code | Frequency | Fee Per Session |
|---|---|---|---|
Initial Intake – 60 minutes | 90791 | 1 time | Up to $150 |
Individual Psychotherapy – 60 minutes | 90837 | 1-4 times/a month | Up to $150 |
Individual Psychotherapy – 45 minutes | 90834 | 1-4 times/a month | Up to $150 |
Family/Couples Psychotherapy- 45-60 minutes | 90847 | 1-4 times/a month | Up to $150 |
Additional Session Time as Needed | N/A | As needed | Up to $75/for 30 minutes |
Examples of Estimates for Yearly Charges
(Actual charges vary according to the frequency and duration of services and amount of time spent in each service. For example, if you envision that you will be in therapy for 6 months at a rate of $150/session, every other week (13 sessions), the estimate is $1,950. Also note that other costs may arise, for example, no-show/late cancellation charges of up to the full agreed upon fee per session.)
| Services | Frequency | Total # of Sessions | Fee/Session | Total Yearly Cost Estimate |
|---|---|---|---|---|
| Initial Intake plus Individual/Couples Psychotherapy | 1 time per week | 52 | $150 | $7,800 |
| Initial Intake plus Individual/Couples Psychotherapy | 1 time every other week | 26 | $150 | $3,900 |
Keep in mind, however, that it is simply not possible for a therapist to know, in advance, how many counseling sessions may be necessary, appropriate, manageable or even desirable for a given person or couple. Actual frequency and duration of psychotherapy services will depend at least in part on factors such as the severity of symptoms presented, the client’s circumstances, and complexity of treatment needed. There may be additional services/items that the therapist and client together agree upon over the course of psychotherapy that are not reflected in an initial good faith estimate. It is important to note that a good faith estimate is not a contract binding either the provider or the client.
Should a client question that the actual billed charges substantially exceed the expected charges set forth in a good faith estimate, this matter can be discussed directly with the provider. The initiation of client dispute resolution process will not adversely affect the quality of health care services provided to the client. The therapist can provide you a receipt of services with details on type of service, duration, and CPT code as applicable, upon request, at each visit.
Reach out to the Mindful Counseling Center if you have questions.