Good Faith Estimate for Health Care Services
Under the law, health care providers must give clients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy.
This Good Faith Estimate shows the costs of items and services that are reasonably expected for your mental health care needs for [time period, e.g., 12 months]. The estimate is based on information known at the time it was created.
Services and Fees - Self Pay Clients
Service Description
Rate per Session
- Initial and periodic Diagnostic Evaluation. $160 (2 times a year)
- Individual Psychotherapy - 55 minute session. $130/ 55 minute session
- Family/Couples Therapy - 55 minute session. $130/55 minute session
- **Sessions are weekly or as arranged with your therapist.
- Cancellation fee - $75. *24 hour notice to avoid this fee is required
Disclaimers and Additional Information
- You have the right to request updates to this estimate at any time.
- Our therapists are required to do a Diagnostic Evaluation every 6 months to have an up-to-date diagnosis and treatment plan on file.
- Your credit card to be automatically charged the day of or day after your service.
- For questions or more information about your right to a Good Faith Estimate, visit: https://www.cms.gov/nosurprises
