Your right to understand costs
Good Faith Estimate
Notice for uninsured and self-pay clients
You have the right to receive a Good Faith Estimate
Under federal law, healthcare providers must give clients who do not have insurance—or who are not using insurance—an estimate of the expected charges for non-emergency healthcare items and services.
You may ask Breakroom Therapy for a Good Faith Estimate before scheduling a service. When you schedule care, an individualized written estimate will be provided within the time required by law. The estimate will describe the services reasonably expected to be provided and their anticipated charges.
Current self-pay fees
- Individual therapy: $130 per session.
- A limited number of reduced-fee appointments are available. Inquire during your free consultation.
- Couples therapy: $175 per session.
These published fees provide general information and do not replace the individualized Good Faith Estimate provided for your anticipated course of care.
If the final bill is substantially higher
If you receive a bill that is at least $400 more than the total expected charges listed on your Good Faith Estimate, you may be eligible to use the federal patient-provider dispute resolution process.
Keep a copy of your Good Faith Estimate. For questions or more information about your rights, visit cms.gov/nosurprises or call 1-800-985-3059.
Requesting an estimate
Use the consultation or practice contact method on the main website and state that you would like a Good Faith Estimate. Asking for an estimate does not require you to begin treatment. Written correspondence may be mailed to Breakroom Therapy, P.O. Box 4041, Orange, CA 92863.