Good Faith Estimate
Your right to a Good Faith Estimate
Under the No Surprises Act, you have the right to receive a Good Faith Estimate of expected charges before receiving healthcare services. This applies to you if you are uninsured, or if you are insured but not planning to use your insurance for sessions with this practice.
A Good Faith Estimate shows the cost of items and services that are reasonably expected for your healthcare needs. The estimate is based on information known at the time it is created. It does not require you to obtain services from this provider.
Last updated April 2026
What the estimate includes
Your Good Faith Estimate will include the following information:
The expected cost per therapy session ($300)
The billing code used for services (CPT code 90837 — Individual Psychotherapy, 60 minutes)
An estimated number and frequency of sessions for a 12-month period
The diagnosis or reason for services
Your provider's name, credentials, and contact information
How to request your Good Faith Estimate
You will automatically receive a Good Faith Estimate before your first appointment if you are uninsured or self-pay. You may also request one at any time by contacting this practice directly.
Phone: (240) 424-5511
Email: drelizabethgordon@gmail.com
If your bill exceeds the estimate
If you are billed for an amount that is $400 or more above what your Good Faith Estimate stated, you have the right to dispute the bill. For questions or to start a dispute, visit www.cms.gov/nosurprises or call 1-800-985-3059.