What is a Good Faith Estimate?

What is a Good Faith Estimate?
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The Good Faith Estimate is a new rule that applies to medical providers to help patients and clients make informed decisions by having a clear understanding of the anticipated cost of care.

As of January 1, 2022, under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.

Under the law, health care providers – including therapists and other mental health practitioners – need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive an estimate explaining how much your medical care will cost, including the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

The cost of services depends on a number of factors including your provider’s fee, frequency of services, and duration of treatment. You can receive an estimate of service costs as described below.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

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