Ahava Wellness Good Faith Estimate
As of January 1, 2022, you have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost under the No Surprises Act.
Under the law, healthcare providers need to give patients an estimate of the bill for medical items and services. Below you will find my session rates and estimates of the cost to best assist you.
Cost for First (Intake) Psychotherapy Session: $165.00 (CPT Code 90791/ 55 Minutes)
Cost Per Psychotherapy Session: $150.00 (CPT Code 90837/53 Minutes)
Cost for Crisis Session (Includes after hours or weekends) $175.00 per hour + 100.00 per 30 minutes after the first hour.
Estimate for 4-5 Sessions per month for weekly sessions: $600.00/$750.00
To make best progress, I recommend that new clients begin with weekly sessions, for at least 12 weeks (Est. total: $1,800.00) This allows me the necessary time to assess and understand your presenting concerns, build our rapport, and begin any immediate skill-building you may need.
After this initial period, most clients either continue at this frequency or reduce it to biweekly depending on their progress and needs at that time.
You and I (your therapist) will work collaboratively to ensure you are only attending sessions as needed and as deemed effective/helpful by you.
Due to the fact that your treatment planning is ongoing and dependent on your individual progress and needs, we would like you to be aware that 48 sessions a year (weekly schedule) would be $7,200.00 for a year of therapy and that 24 sessions a year (bi-weekly sessions) would be $3,600 for a year of therapy (I take off 4 weeks per year) to assist you in your estimation.
Monthly sessions are only recommended for those that have already met their primary treatment goals and when seeking ongoing wellness support is appropriate for their longer-term wellness goals.
Any diagnostic codes will not be identifiable until you begin treatment. Any diagnoses will not affect the cost of the session but would inform your treatment plan which would include suggested session frequency however, any diagnoses will not affect the cost of the session but will inform your treatment plan which would include suggested session frequency.
If you are billed for $400 more than this Good Faith Estimate (GFE), you have the right to dispute the bill. You may contact Michelle Langley at email@example.com to let me know the billed charges are at least $400 higher than the GFE.
You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.
There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this GFE. If the agency disagrees with you and agrees with Ahava Wellness|Michelle Langley, LPC, you will have to pay the higher price.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call CMS at 1-800-985-3059 .
This Good Faith Estimate is not a contract. It does not obligate you to accept the services listed.