Dear Clients,

As of 2022, California passed the No Surprises Act (H.R. 133) – a law which requires that all healthcare providers (including psychotherapists) provide a ‘Good Faith Estimate’ to their clients/patients who don’t have insurance or who are not using insurance for the expected charges for medical and mental health services.

Under the law, you have the right to receive a Good Faith Estimate for the total expected cost of any non- emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

---

If you are a new client starting services with us in 2022, we will provide this No Surprises Act Disclosure and a Good Faith Estimate in your Intake Forms via our Client Portal. If you are a previously existing client and would like a Good Faith Estimate for services, please contact your therapist directly and we’d be happy to furnish one.