Notice of Your Right to a Good Faith Estimate
The "No Surprises Act"
Last Updated: February 2026
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.
What This Means for You
You have the right to receive a Good Faith Estimate explaining how much your medical care will cost. Under the law, health care providers must give patients who don’t have insurance or aren't using it an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
We will provide 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.
Good Faith Estimates at Our Practice
Sandra Pacheco, LMHC provides transparent fee structures for all individual psychotherapy, LGBTQIA+ affirmative counseling, and the psychotherapeutic integration components of Ketamine-Assisted Psychotherapy (KAP).
Because psychotherapy length and frequency depend heavily on an individual's unique needs and progress, your Good Faith Estimate will project the expected costs of services over a specific period (e.g., a 12-month timeline). You are never obligated to complete the full estimated duration of therapy and may pause or terminate services at any time.
(Note: For clients undergoing KAP, the medical intake, evaluation, and prescription costs handled by our partners at Journey Clinical will be estimated and billed separately by their medical team.)
Questions or More Information
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the No Surprises Help Desk at 1-800-985-3059.
If you have any questions about our estimates, please contact us at:
Sandra Pacheco, LMHC