Good Faith Estimate and Service Fees

Effective January 1, 2022, a ruling went into effect called the “No Surprises Act,” which requires mental health practitioners to provide a “Good Faith Estimate” (GFE) to patients who do not have insurance or patients who have insurance but are out-of-network. This ruling requires a diagnosis before the initial visit, so you will be provided with a generic or provisional diagnosis. If you wish to have a formal diagnosis, this will be discussed after your initial session.

The Good Faith Estimate’s purpose is to show the cost of services to avoid an unreasonably large bill. Your treatment and cost of treatment will vary based on your individual needs, amount of therapy sessions needed/wanted, and the type and length of services you attend. There is no way of predicting the exact amount of therapy sessions or services that will be needed however you will be provided with some examples of total cost of treatment for reference. Please remember you can always discuss billing, cost, treatment plan, length of sessions, and amount of sessions at any time.

The Good Faith Estimate is NOT a contract and does not obligate you to obtain any services from the Bell Center for Anxiety and Depression. The Good Faith Estimate is not intended to serve as a recommendation for treatment or prediction to attend a specific number of psychotherapy visits nor does it provide an all-inclusive treatment plan. Therapy is and always will be voluntary and unique to fit your specific needs.

Bell Center’s Services & Fees effective through December 31, 2022

Initial Diagnostic Evaluation

45-53 Minutes

$215 CPT Code 90791
45-53 Minute Psychotherapy $215 CPT Code 90834
30 Minute Psychotherapy $150 CPT Code 90832
60 Minute Psychotherapy $260 CPT Code 90837
75 Minute Psychotherapy $325 CPT Code 90837
105 Minute Psychotherapy $430 Column 3 Value 5

Please note, if you book a session and are late you are still responsible for the full fee. Dr. Bell will typically wait 30 minutes past the session start time as it is understandable that things happen and people run late. However, after 30 minutes you will be charged the no show/late cancellation fee. If this is unclear, please discuss this during your first session.

Examples of Good Faith Estimates

Please note these are estimates and your exact cost of treatment will depend on the amount of sessions you wish to have weekly, length of sessions, and additional services requested.

Example 1: $215 Initial session + $215 session x 12 weeks = $2,795

Example 2: $215 Initial session fee plus $215 session x 24 weeks = $5,375

If you attend therapy twice a week or for longer than 6 months, your total cost of service will be higher. You may use the equation above to calculate your total cost of service. If you are unsure, please discuss this during a session.

The Bell Center will bill you after each session at midnight the day of service. Should you feel your bill is unreasonably high (in excess of $400) than the equation outlined in your Good Faith Estimate, you may dispute the charges. For more information you may visit www.cms.go/nosuprises or call (800) 368-1019. Keep a copy of your Good Faith Estimate in a safe place and again if you should have any questions, please feel free to discuss it at any point during one of your sessions.

Experience • Expertise • Effectiveness