Good Faith Estimate
Townsend Psychological Services, PLLC
You have the right to receive a “Good Faith Estimate” explaining how much your
medical and mental health care will cost. Under Section 2799B-6 of the Public
Health Service Act, health care providers and health care facilities are required to
inform individuals who are not enrolled in a plan or coverage or a Federal health
care program, or not seeking to file a claim with their plan or coverage both orally
and in writing of their ability, upon request or at the time of scheduling health care
items and services, to receive a “Good Faith Estimate” of expected charges.
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 expected charges for
medical services, including psychotherapy services.
• You have the right to receive a Good Faith Estimate for the total expected cost
of any non-emergency items or services.
• You can ask your health care provider, and any other provider you choose, for a
Good Faith Estimate before you schedule a 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 call (800) 368-1019Good Faith Estimate,
visit www.cms.gov/nosurprises or call 800-985-3059.
Townsend Psychological Services
Good Faith Estimate
Beginning January 1, 2022, federal laws regulating client care have been updated
to include the “No Surprises” Act. Under the law, healthcare providers need to give
clients who don’t have insurance or who are not using insurance an estimate of the
bill for health care items and services called a “Good Faith Estimate” (GFE)
explaining how much your medical care will cost.
This new regulation is designed to provide transparency to clients regarding their
expected health care expenses and to protect them from surprises when they
receive their charges. It allows clients to understand how much their health care
will cost before they receive services.
There are a number of factors that make it challenging to provide an estimate on
how long it will take for a client to complete therapeutic treatment, and much
depends on the individual client and their goals in seeking therapy. Some clients
are satisfied with a reduction in symptoms while others continue longer because it
feels beneficial to do so. Others begin to schedule less frequently and may continue
to come in when issues arise. Ultimately, as the client, it is your decision when to
stop therapy.
At Townsend Psychological Services, we must provide a diagnosis for all clients
for both ethical and legal reasons -- as well as required by the "No Surprises Act".
A formal diagnosis occurs after an assessment has been completed. That will take
place 1-5 sessions after beginning psychotherapy. If you choose to decline a formal
diagnosis, we will not update the GFE. It is within your rights to decline a
diagnosis per state and federal guidelines.
Common Diagnosis Codes at Townsend Psychological Services:
Below are common diagnosis codes at Townsend Psychological Services; however,
the list is not exhaustive. With that said, diagnosis codes can change based on
many factors. Please speak to your therapist with any questions or concerns.
Adjustment Disorder (F43.23)
Depression (F32.9)
Anxiety (F41.1)
PTSD/Post Traumatic Stress Disorder (F43.10)
Townsend Psychological Services recognizes every client's therapy journey is
unique. How long you need to engage in therapy and how often you attend sessions
will be influenced by many factors including:
Your schedule and life circumstances
Therapist availability
Ongoing life challenges
The nature of your specific challenges and how you address them
Personal finances
You and your therapist will continually assess the appropriate frequency of therapy
and will work together to determine when you have met your goals and are ready
for discharge and/or a new Good Faith Estimate will be issued should your
frequency or needs change.
Common Services at Townsend Psychological Services:
90837: Individual Psychotherapy, 60 minutes
Where services will be delivered.
Townsend Psychological Services provides services in the office and via
teletherapy
Townsend Psychological Service Office Location:
1840 Memorial Drive, Clarksville, TN 37043
Provider Information
Provider Names:
o Rebecca Townsend, LPC-MHSP-Supervisor; SrLPE-HSP
o Lisa Syner, LPC-MHSP (temp)
o Marina Aldana, Post-Graduate Counselor
o Amber Heggie, Post-Graduate Counselor
Good Faith Estimate
For a good faith estimate: the amount you would owe if you were to attend therapy
for 52 sessions in a year (weekly, without skipping any weeks for holidays, break,
vacation, unplanned events/sickness, etc.). The "Good Faith Estimate" requires
practitioners to provide an exact estimate and not a range. Out of an abundance of
caution and transparency, we will only quote weekly appointments.
Rebecca Townsend:
90837: Individual Psychotherapy, 60 minutes ($175) for 52 weeks: $9100
Lisa Syner:
90837: Individual Psychotherapy, 60 minutes ($125) for 52 weeks: $6500
Marina Aldana:
90837: Individual Psychotherapy, 60 minutes ($95) for 52 weeks: $4940
Amber Heggie:
90837: Individual Psychotherapy, 60 minutes ($95) for 52 weeks: $4940
The above examples are provided to give an idea of the financial expectations for a
calendar year. The frequency and duration is dependent on your individual needs
and goals. We look forward to talking with you and answering any questions you
may have about the “No Surprises” Act and Good Faith Estimates.
