Good Faith Estimate

Starting January 1, 2022, Federal law requires mental health providers to provide an estimate of costs of services to private pay clients known as a “good faith estimate”.

My Private Pay rate is based on a sliding scale from $160 to $240 per session based upon each client’s reported income for sessions of a minimum of 50 minutes each. First-time sessions that included a psychological evaluation range in cost from $240 to $340.

This estimate is the range of costs that is likely for most new private pay patients. Until I do an initial evaluation and we start to work together, I will not have a clear picture of your specific diagnosis, issues and needs, nor estimated time necessary for therapy. I typically see therapy patients for a time period ranging from 10 sessions - 40 sessions for a total cost ranging from between $1,840 to $9,940 depending upon one’s agreed amount of payment.

Typical Diagnoses I treat include (but not limited to):

  • Adjustment Disorders

  • Anxiety Disorders including Generalized Anxiety Disorder, Panic Disorder, and Social Anxiety.

  • Depressive Disorders including Major Depressive Disorder, Bipolar, Persistent Depressive, and Related Disorders.

  • Trauma and Stressor- Related Disorders including PTSD and Acute Stress Disorder.

Disclaimer

Each private pay client will be provided with a Good Faith Estimate form to read and sign indicating receiving and understanding it. This Good Faith Estimate will show the costs of services that are reasonably expected for the expected services to address your mental health care needs. The estimate is based on the information known to me when I conduct the estimate. When we meet, my initial intake process typically takes 1-2 sessions during which we we formulate a treatment plan based on your diagnosis, current functioning, current stressors, and systemic stressors, which will help guide a more informed plan for our therapy.

The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, I will give you a new estimate for services.

The Good Faith Estimate each client receives is not a contract. It does not obligate you to accept the services listed. The information provided in the Good Faith Estimate is only an estimate, as actual items, services, or charges may differ.

Your Rights

Federal law allows you to dispute (appeal) the bill if its over $400 of the most current estimate. Thus, if you are billed $400 or more than the most current Good Faith Estimate, you have the right to dispute the bill.

You may contact Dorian Kondas, Ph.D. at the contact listed above to let me know the billed charges are higher than the Good Faith Estimate. Clients can ask to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available. Dr. Kondas will always try to work with you directly to resolve billing concerns and adjust the Good Faith Estimate as needed. Dr. Kondas is always willing to refund any overpayment of the good faith estimate that was not due to unpredictable complications of care that could not have been fully anticipated at the date of the originally determined estimate. In some cases where treatment may exceed 40 sessions of therapy, a new good faith estimate will be created. 

You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.

There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.

To learn more and get a form to start the process, go to: www.cms.gov/nosurprises or call CMS at 1-800-985-3059.

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call CMS at 1-800-985-3059.