Right to Receive a “Good Faith Estimate”

You have the right to receive a “Good Faith Estimate” explaining how much your behavioral health care will cost.

Under the law, healthcare providers need to give individuals who do not have healthcare coverage or who are not using certain types of healthcare coverage an estimate of the bill for provided services.

• You have the right to receive a Good Faith Estimate (GFE) for the total expected cost of any non-emergency services.
• The Good Faith Estimate does not include any unknown or unexpected costs that may come up during treatment. There may be additional charges if exceptional situations occur.
• Make sure you are given a Good Faith Estimate in writing before your scheduled appointment. You can also ask 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 or appeal the bill.
• Make sure you 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/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.