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Moss & Moon Counseling

No Surprises Act

Good Faith Estimate

As of January 1, 2022, under the No Surprises Act, healthcare providers are required to provide clients who are not using insurance
—or are choosing not to use insurance—with a "Good Faith Estimate" (GFE) of expected charges for services.
This law is designed to prevent unexpected medical bills and to help you better understand and plan for the cost of your care.

What Is a Good Faith Estimate?

A Good Faith Estimate is a notification of the expected cost of services offered to you. It is based on the information known at the
time of scheduling. It includes:

  • The estimated total cost of services you may receive
  • A clear explanation that the estimate is not a contract
  • A statement of your right to dispute a bill that is at least $400 more than the estimate

This estimate is valid for 12 months from the date it is issued and may be updated if your services change or extend significantly.

Your Rights

  • You have the right to receive a written Good Faith Estimate for the total expected cost of your mental health care.
  • You may request an estimate before scheduling a service or at any time during your care.
  • If you receive a bill that is $400 or more above the GFE, you can dispute the bill through a federal process.
  • You are not required to accept or receive services after receiving the estimate.

For questions or more information about your right to a Good Faith Estimate or to initiate a dispute, visit: https://www.cms.gov/nosurprises

Moss & Moon Counseling Policies

At Moss & Moon Counseling, I am committed to transparency and fairness in my billing practices. The following information applies
to your care.

Session Rate:

  • $333 per 75 minute session for a 1:1 session in person or online
  • $400 per 90 minute couples therapy session
  • $999 per 180-240 minute Ketamine Assisted Psychotherapy Session
  • $999 per 180-240 minute extended EMDR session
  • Please be aware that my rate increases by 7% each year on April 20th.

Please note this is not a contract or a commitment to a specific number of sessions. You may continue or end services at any time.