Good Faith Estimate

Last Updated: October 2, 2026

Your Right to a Good Faith Estimate

Under the federal No Surprises Act, individuals who do not have health insurance or who choose not to use their insurance to pay for healthcare services are generally entitled to receive a Good Faith Estimate (GFE) of their expected healthcare costs.

A Good Faith Estimate provides an estimate of the expected charges for your care before services are provided. It is not a bill or a guarantee of the final cost of treatment.

This information applies to services provided by Kori Abarzua, LCSW, PMH-C, in Connecticut, Florida, Vermont, and South Carolina, as applicable.

Who Can Receive a Good Faith Estimate?

You may request a Good Faith Estimate if you:

  • Do not have health insurance

  • Have health insurance but choose not to use it for your therapy services

  • Are receiving services on a self-pay or private-pay basis

  • Would like to know the expected cost of your therapy before beginning treatment

If you are using insurance and your sessions are being billed to your insurance plan, your financial responsibility will depend on your individual insurance benefits, including your deductible, copayment, coinsurance, and other plan requirements.

Private-Pay Fees

My current standard private-pay fees are:

Initial Diagnostic Evaluation: $200
Individual Therapy Session: $175

A limited number of reduced-fee appointments may be available based on availability and individual circumstances. Any agreed-upon reduced fee will be discussed with you in advance.

Specialized services, including EMDR intensives, may have different fees. Any applicable fees will be discussed before scheduling.

Your Individualized Good Faith Estimate

Because therapy is individualized, the number and frequency of sessions needed can vary from person to person.

Your Good Faith Estimate will be based on the services reasonably expected to be provided and may include:

  • The type of service

  • The expected frequency of sessions

  • The expected duration of treatment

  • The expected charge for each service

  • The estimated total cost for the period covered by the estimate

For example, if weekly therapy is reasonably expected for a specific period, your estimate will reflect the anticipated number of sessions during that period.

Your estimate may be updated if your treatment needs, frequency of appointments, or services change significantly.

A Good Faith Estimate is an estimate of expected charges, not a commitment to a specific length of treatment. You are not required to continue therapy for the entire period reflected in an estimate.

When You Will Receive Your Estimate

If you are uninsured or choose not to use insurance, a Good Faith Estimate will generally be provided when required by applicable law, including when services are scheduled sufficiently in advance or when you request an estimate.

You may request a Good Faith Estimate at any time by contacting me.

If Your Bill Is Higher Than Your Estimate

If you are uninsured or self-pay and your final bill from me is at least $400 more than the amount included in your Good Faith Estimate, you may have the right to dispute the bill through the federal Patient-Provider Dispute Resolution (PPDR) process.

To qualify for the federal dispute process, certain requirements apply, including that you received a Good Faith Estimate before receiving the services and that the dispute is initiated within the applicable timeframe. Currently, CMS states that the dispute must generally be initiated within 120 calendar days of the initial bill.

You should keep your Good Faith Estimate and compare it with your final bill.

For more information about the federal dispute process, visit the Centers for Medicare & Medicaid Services (CMS).

Insurance and Out-of-Network Benefits

If you choose to use insurance, your final out-of-pocket responsibility will depend on your insurance plan and benefits.

I currently work with insurance through third-party billing platforms. I may also provide a superbill upon request for clients who are seeking reimbursement through an out-of-network benefit.

A Good Faith Estimate is generally intended for individuals who are uninsured or who choose not to use their insurance for the services being estimated.

Request a Good Faith Estimate

If you would like to receive a Good Faith Estimate before beginning therapy, please contact me:

Kori Abarzua, LCSW, PMH-C
Licensed in Connecticut, Florida, Vermont, and South Carolina
Email: koriabarzualcsw@gmail.com

I will provide an individualized estimate based on the services and frequency of care reasonably expected at the time the estimate is prepared.