Good Faith Estimate
You have the right to receive a Good Faith Estimate explaining how much your health care is expected to cost.
The No Surprises Act provides protections against certain unexpected medical bills. For people who are uninsured or choosing not to use insurance, these protections generally include a written estimate of expected charges before care and access to a federal process for disputing certain bills.
This page is general information, not your individualized Good Faith Estimate. Your written estimate will reflect the services and expected charges associated with your care.
Estimated service costs
The following prices are per appointment. Your total expected cost depends on the services and number of appointments included in your treatment plan.
Initial Psychiatric Evaluation
$375 Per appointment
Standard Medication Follow-Up
$200 Per appointment
Complex Medication Follow-Up
$325 Per appointment
These are practice appointment charges, not an estimate of your insurance copayment or deductible. Medications, laboratory tests, or services billed by other providers may involve separate charges. Request estimates directly from those providers.
When you should receive an estimate
For eligible uninsured or self-pay patients, the following deadlines apply:
| When you schedule or ask | Written estimate deadline |
|---|---|
| Appointment scheduled 3–9 business days in advance | Within 1 business day after scheduling |
| Appointment scheduled 10 or more business days in advance | Within 3 business days after scheduling |
| You request an estimate before scheduling | Within 3 business days after your request |
When care is scheduled fewer than 3 business days in advance, the federal scheduling requirement generally does not require an estimate before that appointment. Good Faith Estimates are not provided during emergency care.
Your rights and your estimate
- You may request an estimate before deciding whether to schedule care.
- Your estimate should itemize the expected charges. You may receive it on paper or electronically.
- An estimate is not a bill and does not require you to receive the services listed.
- Keep a copy or photograph of your estimate so you can compare it with your bill.
Unexpected care may affect final charges. An estimate does not waive your right to challenge an eligible bill.
If your bill is higher than your estimate
If a provider or facility bills you at least $400 more than that provider’s or facility’s Good Faith Estimate, you may qualify for the federal patient-provider dispute resolution process.
You must start the dispute within 120 calendar days of receiving the initial bill. An independent reviewer can determine the appropriate payment amount.
You may contact us about a billing question, but doing so does not extend the federal dispute deadline. If you did not receive a required estimate, you can submit a complaint to CMS.
Official information and help
- Understanding Good Faith Estimates — CMS
- Your rights, bill disputes, and complaints — CMS
- No Surprises Act consumer resources
No Surprises Help Desk: 1-800-985-3059
Request your Good Faith Estimate
Contact A.M. Psychiatry, LLC and let us know you would like an estimate for uninsured or self-pay care.
Please avoid sending sensitive medical information by ordinary email. Use Spruce for private health information.