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Legal

Good Faith Estimate

Your right to know what care costs, in writing, before it happens.

Before this goes live The content below reflects current federal requirements as of this writing (the $400 dispute threshold and timing windows are unchanged since 2022). Before publishing, add your actual NPI number where marked, and have this reviewed — No Surprises Act compliance is billing-specific, and this is meant as an accurate starting draft, not a substitute for that review.

Last updated: [date]

Your right to a Good Faith Estimate

Under the federal No Surprises Act, if you don't have insurance, or you have insurance but choose not to use it for your care, you have the right to receive a Good Faith Estimate of what your therapy will cost before you receive it.

When you'll receive it

A written estimate is provided:

  • Within 1 business day of scheduling, if your first appointment is 3–9 business days out.
  • Within 3 business days of scheduling, if your first appointment is 10 or more business days out.
  • Any time you ask for one, even before scheduling.

A single estimate can cover recurring sessions with the same expected cost for up to 12 months.

What it includes

  • Stacey Stefanski's name and National Provider Identifier (NPI): [NPI number]
  • The expected service type and billing code(s)
  • The expected charge per session: $150
  • A note that this is an estimate, not a final bill — the actual cost may differ if your care ends up needing more or fewer sessions than estimated

If your bill is higher than the estimate

If your final bill is $400 or more above your Good Faith Estimate, you have the right to dispute it. You have 120 calendar days from the date of the bill to start a dispute through the federal Patient-Provider Dispute Resolution process, administered by the Department of Health and Human Services. There's a small administrative fee to file. While a dispute is pending, we won't pursue collection on the disputed amount.

Questions or requests

To request a Good Faith Estimate, or with questions about one you've received, contact Stacey Stefanski through the contact form or (314) 948-3838.

For more information about your rights under the No Surprises Act, visit cms.gov/nosurprises or call 1-800-985-3059.