Good Faith Estimates
As a self-pay, out-of-network client, you are entitled to receive this “Good Faith Estimate” of what the charges could be for psychotherapy services provided to you. While it is not possible for us to accurately predict how many psychotherapy sessions may be necessary or appropriate in advance, this document provides an estimate of the cost of services provided. Your total cost of services will depend upon the number of psychotherapy sessions you attend, your individual circumstances, and the type and amount of services that are provided to you. This estimate is not a contract and does not obligate you to obtain any services from me, nor does it include any services rendered to you that are not identified here.
This Good Faith Estimate is not intended to serve as a recommendation for treatment or a prediction that you may need to attend a specified number of psychotherapy visits. The number of visits that are appropriate in your case, and the estimated cost for those services, depends on your needs and what you agree to in consultation with your therapist. You are entitled to disagree with any recommendations made to you concerning your treatment and you may discontinue treatment at any time.
The fee for a 50-minute intake appointment (in-person or via telehealth) is $250.00 and a 53-minute individual therapy or couples therapy visit (in-person or via telehealth) is $200.00. Most clients will attend to only one intake appointment as their first appointment and then one visit per week, but the frequency of psychotherapy visits that are appropriate in your case may be more than once per week, depending upon your needs. Based upon a fee of $250.00 for your intake appointment and $200.00 per visit, if you attend one visit per week, your estimated charge would be $850.00 for four visits provided over the course of one month; $1650.00 for eight visits over two months; or $2450.00 for 12 visits over three months. If you attend therapy for a longer period, your total estimated charges will increase according to the number of visits and length of treatment.
|Number of Weeks||Total estimated charges for 1 session per week|
|4 weeks |
(approximately 1 month of services)
(approximately 3 months of services)
(approximately 6 month of services)
(approximately 1 year of services)
You have a right to initiate a dispute resolution process if the actual amount charged to you substantially exceeds the estimated charges stated in your Good Faith Estimate (which means $400 or more beyond the estimated charges).
You are encouraged to speak reach out to me at any time about any questions you may have regarding your treatment plan, or the information provided to you in this Good Faith Estimate.