No Surprises Act: What You Need to Know

You have the right to receive a Good Faith Estimate that explains your medical care costs. 

Under the law, health care providers must provide uninsured patients or those not using insurance with an estimate of the bills for medical items and services. 

All self-pay and uninsured patients must be informed that a Good Faith Estimate of charges is available. This estimate of expected medical care costs should be provided to the patient within specified time frames (for example, for services scheduled at least 3 days prior to the appointment date, no later than 1 business day after scheduling). 

While the estimate is not binding, it allows patients to challenge a bill if the charges exceed the estimated amount by more than $400. 

If there are any changes to the information in the Good Faith Estimate, a new estimate should be issued. The estimate can also include anticipated charges for recurring services expected to be provided within the next 12 months (like 10-20 psychotherapy sessions). If treatment continues beyond 12 months, the provider must provide a new estimate. Remember, this is not a treatment recommendation but a form designed to prevent surprise bills from unexpected medical care costs. 

• 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. 

• Ensure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also request a Good Faith Estimate from your health care provider or any other provider you choose before scheduling an item or service. 

• Should you receive a bill for a session that is at least $400 more than your Good Faith Estimate, you can dispute the bill. 

• It’s important to save a copy or picture of your Good Faith Estimate. 

For more information about your rights regarding a Good Faith Estimate, you can visit www.cms.gov/nosurprises.