Good Faith Estimate Notice
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or 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 or call (330) 261-0809.
Fees for Services
Initial Psycholigical Evaluation
This is your first session. Because assessment is usually included in the session, as well as more complex assessment and diagnosis, this session fee is $200.
Psychotherpapy
These 45-50 minute sessions are ongoing psychotherapy and are charged at $150/session. This includes any additional sessions that are needed to complete the assessment process. A typical course of treatment is 12-16 sessions.
Couple and Family Therapy
These 45-50 minute sessions include at least two family members or romantic partners. The fee per session is $150. A typical course of treatment is 12-16 sessions, though more or less may be needed based on your situation.