Good Faith Estimate

Your Right to a Good Faith Estimate

Under the No Surprises Act, clients who are uninsured or who choose not to use insurance have the right to receive a Good Faith Estimate explaining the expected cost of services before beginning care.

A Good Faith Estimate is not a bill. It is an estimate based on the information known at the time it is created.

Services Provided

Ryan Marler, LCSW provides individual telehealth counseling for adults, teens, and children ages 10 and up.

Services are available only to clients who are physically located in Washington or Florida at the time of session.

Scheduling and Billing Through Headway

Ryan uses Headway for scheduling, insurance verification, billing, and secure telehealth access.

If you use insurance through Headway, Headway will provide an estimated session cost based on your insurance benefits before you book. Final costs may vary depending on your insurance plan, deductible, copay, coinsurance, and insurer review.

If you are uninsured or choose not to use insurance, you may request a Good Faith Estimate before beginning services.

Estimated Costs

Your estimated cost depends on the type and frequency of services.

Common service types may include:

Initial evaluation
CPT Code: 90791
Estimated fee: Provided through Headway

Individual therapy session
CPT Code: 90837 (60 minute) or 90834 (45 minute)
Estimated fee: Provided through Headway

The total estimated cost of care will vary based on how often you attend therapy and how long you continue services.

Examples may include:

Weekly sessions for 12 months
Biweekly sessions for 12 months
Monthly sessions for 12 months

Your actual number of sessions may be higher or lower depending on your needs, goals, availability, and treatment plan.

What the Estimate Includes

A Good Faith Estimate may include:

Client name and date of birth
Provider name and contact information
Service description
Applicable CPT codes
Estimated cost per service
Estimated total cost over a period of care
Any known additional fees
Required federal notices about your rights

Changes to Your Estimate

Your Good Faith Estimate is based on information available at the time it is created. If your treatment needs, frequency of care, fees, or services change, you may receive an updated estimate.

Your Right to Dispute a Bill

If you receive a bill that is at least $400 more than your Good Faith Estimate, you may have the right to dispute the bill through the federal patient-provider dispute resolution process.

You can learn more at:

CMS No Surprises Act information: www.cms.gov/nosurprises or call 1-800-985-3059

Requesting a Good Faith Estimate

To request a Good Faith Estimate, contact Ryan before beginning services.

Ryan Marler, LCSW
Phone: (904) 675-8881
Health and Life PLLC