The Center for Self

Good Faith Estimate of

Health Care Items and Services

Last updated July 12, 2024

Your right to receive a "Good Faith Estimate"

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. 

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. 

  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

  • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or ask your provider for a Good Faith Estimate.

Good Faith Estimate

NPI Information:

  • The Center for Self: 1477237931

  • Sarah Blader (Clinical Social Worker): 1932616802

  • Rebecca Price (Clinical Social Worker): Under the supervision of Sarah Blader

Diagnosis & Code:

The price of sessions are the same regardless of your diagnosis.

  • 90791 (Therapy Intake) $200

  • 90832 (Individual Therapy, 16-37 Minutes) $130

  • 90834 (Individual Therapy, 38-52 Minutes) $145

  • 90837 (Individual Therapy, 53+ Minutes) $170

  • 90839 (Crisis Session - 60 Minutes) $200

    *This is an extensive, not an exhaustive, list and your provider may deem other services medically necessary.*

Estimated Cost of Services:

  • We will collaborate to decide how frequently to schedule sessions. This is based on several factors: severity of symptoms/issues, scheduling, and cost. This estimated number of sessions is 15, generally, sessions start weekly, then every other week, and then monthly.

  • One therapy intake and fourteen individual therapy sessions with a clinical social worker $2580.