Notice: ​You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost

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Beginning January 1, 2022, federal laws regulating client care have been updated to include the “No Surprises” Act. 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 healthcare services, including psychotherapy 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.

This new regulation is designed to provide transparency to patients regarding their expected medical expenses and to protect them from surprises when they receive their medical bills. It allows patients to understand how much their health care will cost before they receive services.

There are a number of factors that make providing an accurate estimate for therapeutic treatment challenging, as much depends on the individual client and their goals, and it is impossible for a therapist to predict how many sessions a client may need and/or elect to receive. Therapy "success" is subjective; some clients are satisfied with a reduction in symptoms, while others continue as long as it feels helpful. Some taper off from therapy gradually, scheduling less frequently as symptoms improve;  others may leave more abruptly and/or choose to come back at a later date. As the client, it is your right to decide when to stop therapy, and this decision can be influenced by many factors, including:

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• Your schedule and life circumstances

• Therapist availability

• The nature of your specific challenges and how you choose to address them

• Personal finances​

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All medical services must be billed based on diagnosis and service codes. Please ask your therapist if you are unsure of your diagnosis.

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Common Diagnosis Codes:

• PTSD/Post-traumatic stress disorder (F43.10)

• Other reactions to severe stress (F43.89)

• Adjustment disorder (F43.23)

• Major depressive disorder (F32.9)

• Generalized anxiety disorder (F41.1)

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​Common Services:

• 90791: Intake evaluation ($250)

• 90837: 53 minute psychotherapy session ($180)

• Therapy intensive sessions (not billable through insurance): minimum 4 hours ($150/hour)

All services are conducted online through telehealth or in person at a location chosen in collaboration between client and therapist.

​Provider Information​

Katie Allen, NPI: 1790459014, TAX ID: 99-2270125

Email: katie@odysseywellnesstherapy.com Phone: 206-424-8434

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Odyssey Wellness Good Faith Estimate​

​This estimate assumes 52 sessions in a year with no missed sessions due to holidays, breaks, vacation, illness, etc. The "Good Faith Estimate" requires practitioners to provide an exact estimate and not a range.

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• 90791: Intake session ($250) plus 90837: 53 minute psychotherapy session ($180) weekly for 52 weeks: $9,610

• 90791: Intake session ($250) plus 3 intensive psychotherapy sessions ($1200) and follow up 90837: 53 minute psychotherapy session ($180): $4,200

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.

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​Good Faith Estimate Disclaimer

• This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs. The estimate is based on information known at the time the estimate was created. 

• The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill. 

• If you are billed for more than this Good Faith Estimate, you have the right to dispute the bill. 

• You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days of the date on the original bill. 

• There is a fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on your Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount. 

• To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call 800-985-3059. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059. Keep a copy of this Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed a higher amount.

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​This is the public disclosure of the “Good Faith Estimate.”