Good Faith Estimate

Effective Date: 8/14/25

Your Right to Receive a Good Faith Estimate of Expected Charges
Under the No Surprises Act, healthcare providers are required to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.

1. What is a Good Faith Estimate?

A Good Faith Estimate is an estimate of the expected charges for healthcare items and services that are reasonably expected to be provided in conjunction with a scheduled or requested item or service. This estimate is provided to uninsured (or self-pay) patients, or to patients who choose not to use their insurance.

You have the right to receive a Good Faith Estimate for the total expected cost of any healthcare services, including therapy and mental health services, from Trauma Education & Support Services (TESS).

2. When You'll Receive an Estimate

We will provide you with a Good Faith Estimate in the following situations:

  • When you schedule a service at least 3 business days in advance

  • Upon request, if you ask for an estimate

  • When you are uninsured (don't have health insurance)

  • When you choose not to use your health insurance for services

  • When you are seeking services not covered by your insurance

3. Our Service Rates

The following table provides our standard rates for mental health services. Your actual costs may vary based on your specific treatment needs and the number of sessions required.

Important: This is an estimate based on information known at the time the estimate was created. Actual services and charges may differ from this Good Faith Estimate based on changes in treatment during the course of your care.

4. Factors That May Affect Your Costs

Several factors may influence the final cost of your treatment:

Treatment-Related Factors

  • Complexity of your mental health concerns

  • Number of therapy sessions needed

  • Type of therapy approaches used

  • Need for specialized services or assessments

  • Coordination with other healthcare providers

Service-Related Factors

  • Provider experience and specialization level

  • Session length modifications

  • Emergency or crisis intervention needs

  • Documentation and report preparation

  • Consultation with other professionals

5. Payment Options and Financial Assistance

Payment Methods

We accept the following forms of payment:

  • Cash or check

  • Credit and debit cards

  • Health Savings Account (HSA) cards

  • Flexible Spending Account (FSA) cards

  • Payment plans (arranged in advance)

Financial Assistance

We understand that mental health care is an important investment. We offer:

  • Sliding scale fees based on income (limited availability)

  • Payment plans to spread costs over time

  • Student and senior discounts (where applicable)

  • Information about community mental health resources

6. Your Rights Under the No Surprises Act

You have the right to:

  • Receive a Good Faith Estimate of expected charges before receiving services

  • Ask questions about the estimate and request clarification

  • Request an updated estimate if your treatment plan changes

  • Dispute bills that exceed your Good Faith Estimate by more than $400

  • Choose your provider and make informed decisions about your care

Patient-Provider Dispute Resolution

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill through a patient-provider dispute resolution process. You must start this process within 120 calendar days of the date on the bill.

7. How to Request a Good Faith Estimate

You can request a Good Faith Estimate by:

  • Calling our office at (916) 274-4947

  • Emailing us at billing@tessprograms.org

  • Requesting one during your appointment scheduling

  • Using the form below to submit your request online

Request Your Good Faith Estimate

Complete this form to receive a personalized estimate for your mental health services.

First Name *

Last Name *

Email Address *

Phone Number

Type of Service Requested *(Select a service)

  • Individual Therapy (Adult)

  • Child/Adolescent Therapy

  • Couples Therapy

  • Family Therapy

  • Group Therapy

  • Initial Assessment

  • Other (please specify)                         

Expected Frequency of Sessions (Select frequency)

  • Weekly

  • Every other week

  • Monthly

  • As needed                         

Insurance Status * (Select your insurance status)

  • No insurance (self-pay)

  • Have insurance but not using it

  • Out-of-network benefits

  • Need to verify coverage                         

Additional Information

Request Good Faith Estimate

8. Timeline for Receiving Your Estimate

We will provide your Good Faith Estimate within the following timeframes:

  • Scheduled services (3+ days in advance): At least 1 business day before your appointment

  • Scheduled services (less than 3 days): Upon request

  • Upon request: Within 3 business days of your request

  • Online requests: Within 1-2 business days

9. Questions and Concerns

Need Help or Have Questions?

Our billing and administrative team is here to help you understand your costs and payment options.

Trauma Education & Support Services (TESS)

1601 Response Road, Ste. 230
Sacramento, CA 95815

Phone: (916) 274-4947

Billing Email: billing@tessprograms.org

General Email: info@tessprograms.org

10. Additional Resources

For more information about your healthcare rights and the No Surprises Act:


Commitment to Transparency: At Trauma Education and Support Services, we believe in transparent, honest communication about healthcare costs. We're committed to helping you make informed decisions about your mental health care and will work with you to make our services as accessible as possible.