Good Faith Estimate

(Pursuant to the No Surprises Act – Effective August 25, 2025)

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This Good Faith Estimate shows the expected costs for therapy based on the information known at the time it was created. It is not a bill.​

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These estimates are valid for 12 months from the date issued (generally the date services begin) and will be updated if rates or service frequency change. Your actual total may be lower or higher depending on your needs and the length of therapy.

If you are billed $400 or more than your Good Faith Estimate, you have the right to dispute the bill. For more information, visit www.cms.gov/nosurprises or call 1-800-368-1019.

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