No Surprises Act & Good Faith Estimate

Effective Date: 07/23/26

Third Culture Counseling is committed to providing transparent information about the cost of mental health services. If you are paying for therapy without using health insurance (or are choosing not to submit a claim to your insurance), you have rights under the No Surprises Act.

Your Right to a Good Faith Estimate

Federal law requires healthcare providers to give individuals who are uninsured or self-paying a Good Faith Estimate (GFE) of expected healthcare costs before services are provided.

A Good Faith Estimate outlines the anticipated costs of your psychotherapy services based on the information available at the time it is prepared. The estimate is intended to help you understand and plan for the financial aspects of your care.

Who Is Eligible?

You may receive a Good Faith Estimate if you:

  • Are not using health insurance to pay for services.

  • Do not have health insurance.

  • Choose to pay out-of-pocket instead of submitting claims to your insurance plan.

If you are using your health insurance benefits, this requirement generally does not apply.

What Is Included?

Your Good Faith Estimate may include:

  • Initial intake or diagnostic evaluation fees

  • Individual psychotherapy session fees

  • Couples psychotherapy session fees

  • Consultation services (if applicable)

  • The expected frequency and duration of services, when reasonably anticipated

  • Any other expected costs related to your treatment

Because psychotherapy is individualized, the number of sessions recommended and the total cost of treatment may change over time based on your clinical needs, preferences, and treatment goals.

When Will I Receive My Estimate?

If you schedule services as a self-pay client, you will receive a Good Faith Estimate before your first appointment or as otherwise required by federal law.

You may also request a Good Faith Estimate at any time before beginning treatment.

What If My Costs Change?

Your Good Faith Estimate is an estimate—not a contract.

If your treatment needs change, if additional services become clinically appropriate, or if you choose to continue therapy beyond what was originally anticipated, your costs may differ from the original estimate.

Whenever appropriate, we will discuss any anticipated changes in fees or treatment recommendations with you.

If Your Bill Is Significantly Higher Than Your Estimate

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill through the patient-provider dispute resolution process established by the U.S. Department of Health and Human Services.

There are time limits and eligibility requirements for initiating this process.

For more information, visit:

https://www.cms.gov/medical-bill-rights

or call 1-800-985-3059.

Transparency in Fees

Third Culture Counseling believes that financial transparency is an important part of informed consent and quality care.

Current fees for psychotherapy services are available on the Pricing page. If you have questions about fees, payment options, or whether therapy is a good fit for your needs, please feel free to contact us before scheduling an appointment.

Questions?

If you have questions about Good Faith Estimates, the No Surprises Act, or the cost of services, please contact:

Third Culture Counseling

Zaraar Zahid, LCPC

Licensed Clinical Professional Counselor – Illinois

Email: info@thirdculturecounseling.com

Website: thirdculturecounseling.com