Your Right to a Good Faith Estimate Under the No Surprises Act
If you do not have health insurance or do not plan to use your insurance to pay for psychotherapy, you have the right to receive a Good Faith Estimate of the expected charges for your care.
A Good Faith Estimate is not a bill or a contract. It is an estimate of the charges you can expect for the psychotherapy services you receive.
Psychotherapy Fees
Individual psychotherapy sessions are 45 minutes.
Individual psychotherapy — 45 minutes (CPT 90834): $300 per session
Psychotherapy does not have a predetermined length. The number and frequency of sessions depend on your individual needs and on what we decide together.
Because it is not possible to know in advance how long you will remain in psychotherapy, your Good Faith Estimate describes the expected cost of your sessions rather than predicting the total number of sessions you will attend.
You are fee to discontinue psychotherapy at any time.
Provider Information
Joanna Poppink, MFT
Licensed Marriage and Family Therapist
Arizona License #15632California License #15563Florida License #3982Oregon License #T1863
NPI: 1427713270
EIN: 87-4229305
Psychotherapy services are provided virtually through a secure, HIPAA-compliant video platform.
Your Rights
If you receive a bill from me that is at least $400 more than the amount stated in your Good Faith Estimate, you may be eligible to use the federal patient-provider dispute resolution process. Generally, the dispute must be started within 120 calendar days of receiving the initial bill.
CMS currently confirms the $400 threshold for the patient-provider dispute process.
Your Good Faith Estimate does not require you to receive psychotherapy from me.
Please keep a copy of the individualized Good Faith Estimate you receive. You may need it if you wish to dispute a bill.
You can learn more about Good Faith Estimates and your rights under the No Surprises Act through the Centers for Medicare & Medicaid Services (CMS).
Questions
If you have questions about your Good Faith Estimate or the cost of psychotherapy, please ask me. I'm glad to discuss them with you.
Joanna Poppink, MFT
[email protected]
