Good Faith Estimate

Therapy Costs

The standard fee per 50-minute clinical hour is $150. Payment is requested at the time services are rendered and can be paid with HSA, FSA, credit, or debit cards (Visa, MasterCard, American Express, and/or Discover).

Fees are subject to change. I will inform clients prior to any changes in the standard fee. If you have any questions or concerns about fee changes, please let me know.

Estimated Treatment Costs

Understanding your per-session fee and average treatment duration allows you to estimate total costs (fee × number of sessions). Estimated average total costs are as follows:

Number of Sessions	Estimated Total Cost
6 or fewer sessions	$150 – $900
7–10 sessions	$1,050 – $1,500
11–15 sessions	$1,650 – $2,250
16–20 sessions	$2,400 – $3,000
21 or more sessions	Minimum $3,150

These estimates are based on a per-session fee of $150.

Less Common Costs

Although less common, there may be additional services that must be scheduled separately and are not reflected in this estimate:

• Report writing (psychological evaluations, treatment summaries, etc.): $200/hour, minimum one hour paid in advance. Full fee paid before document is released.
• Phone consultations and other consultations: Billed to the nearest quarter hour at the standard session rate (e.g., a 10-minute call = $37.50).
• Courtroom testimony: $200/hour, minimum three hours payable in advance, regardless of whether testimony is ultimately given.
• Clinical record requests: $100 file location and/or printing fee.

Obtaining a Good Faith Estimate

Clients may ask their clinician for a Good Faith Estimate at any time. The estimate includes, but is not limited to:

• Client name and date of birth
• Description of services in plain language (individual, couple, or family therapy)
• CPT codes most often associated with services at Candid Endeavor:
  • 90832 – Psychotherapy 30 minutes with patient
  • 90834 – Psychotherapy 45 minutes with patient
  • 90837 – Psychotherapy 60 minutes with patient
  • 90846 – Family psychotherapy 50 minutes without patient present
  • 90847 – Family psychotherapy 50 minutes conjoint with patient present
  • 90849 – Multiple-family group psychotherapy
  • 90853 – Group psychotherapy
• Itemized list of expected goods or services
• Diagnostic codes, service codes, and expected charges
• Provider name, NPI, and tax ID
• Office location (in-person or telehealth)

Disclaimer

The Good Faith Estimate is based on information known at the time it was created. It does not obligate or require the client to obtain any listed services, and does not include unknown or unexpected costs that may arise during treatment. Clients could be charged more if complications or special circumstances occur. If this happens, federal law allows clients to dispute the bill.

Right to Dispute

If you are billed for more than your Good Faith Estimate, you have the right to dispute the bill. You may contact me to update the bill to match the estimate, negotiate the bill, or ask about financial assistance. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS).

The dispute process must be started within 120 calendar days of the date on the original bill. There is a $25 fee to use the dispute process.

For more information and to start the process, visit www.cms.gov/nosurprises or call (800) 985-3059.

Keep a copy of your Good Faith Estimate in a safe place — you may need it if you are billed a higher amount.