No Surprises Act

What Is The No Surprises Act?

On January 1, 2022, Congress passed the No Surprises Act (Title 45, section 149.610 of the Code of Federal Regulations), which was designed to protect patients from surprise bills for emergency services at out-of-network (OON) facilities or for OON providers at in-network facilities and holds them liable for in-network cost-sharing amounts. In addition, the No Surprises Act allows uninsured patients to receive a Good Faith Estimate of the cost of care. Under the No Surprise Act, healthcare professionals, including psychologists, are required to provide their private pay clients or clients without health insurance an estimate of the bill for services rendered.

What’s The Goal Of The No Surprises Act?

The primary goal of the No Surprise Act is to protect clients from unexpected medical bills. These surprise bills often occurred when a client received emergency care at an in-network hospital or clinic, but an out-of-network physician provided the service and billed the client separately.

Your Rights

You are entitled to receive a Good Faith Estimate (GFE) of what the charges could be for the psychotherapy services provided to you. While psychotherapists can’t predict, in advance, how many therapy sessions may be necessary for a given person, the notice will provide an estimate of the costs provided.

You can make sure your psychotherapist provides you with a GFE in writing at least 1 business day before your service. You can also ask your psychotherapist or any other providers you choose for a GFE before you schedule an item or service. You can see my fees are transparent for the psychotherapy service in the above section.

If you receive a bill that is at least $400 more than your GFE, you can dispute the bill.

Questions?

For questions or more information about your rights to a GFE or the dispute process please visit the resources below. The initiation of the patient-provider dispute resolution process will not adversely affect the quality of services furnished to you.

For questions or more information about the No Surprises Act and your right to a Good Faith Estimate, call 800-985-3059 or visit www.cms.gov/nosurprises.

For additional information, please read the fact sheet “No Surprises: Understand your rights against surprise medical bills.”