Good Faith Estimate

Effective January 1, 2022
As part of the No Surprises Act, health care providers are required to provide clients who are not using insurance with an estimate of expected charges for services. This is called a Good Faith Estimate (GFE).

What is a Good Faith Estimate?

A Good Faith Estimate outlines the cost of services you can reasonably expect when choosing to pay out-of-pocket (i.e., without insurance). This is to ensure transparency and help you avoid unexpected medical bills.

Who receives a Good Faith Estimate?

You’ll receive a GFE if:

  • You are not using health insurance or

  • You choose to self-pay for services (even if you have insurance)

What’s included in your estimate:

At Holistic Approach Therapy, rates for psychotherapy are as follows:

  • Ongoing Individual Psychotherapy (50-60 minutes): $150

  • Ongoing Relationship/Couples Therapy (50-60 minutes): $200

Your actual costs may be lower or higher depending on the frequency of sessions and the length of your treatment. You have the right to request a Good Faith Estimate at any time.

Please Note:

This estimate is not a contract — you are not required to commit to a specific number of sessions.

  • You can request a revised estimate if your treatment plan changes.

  • If you are billed more than $400 above this estimate, you have the right to dispute the bill.

Questions:

To learn more or request a personalized Good Faith Estimate, contact:
Thalissa Telleria, PhD, LMHC, CST
Email: thalissa@holisticapproachtherapy.com
You can also visit www.cms.gov/nosurprises for more information.