The Good Faith Estimate is a provision of the No Surprises Act (NSA) designed to provide consumers predictability of how much they will be charged for the healthcare services they will receive before their appointment. Under the law, healthcare providers must give their patients an estimate of the bill for medical items and services.

 Under Section 2799B-6 of the Public Health Service Act and its implementing regulations, health care providers, health care facilities, and providers of air ambulance services are required to provide a good faith estimate of expected charges for items and services to individuals who are not enrolled in a group health plan or group or individual health insurance coverage, or a Federal health care program, or a Federal Employees Health Benefits (FEHB) program health benefits plan (uninsured individuals) or not seeking to file a claim with their group health plan, health insurance coverage, or FEHB health benefits plan (self-pay individuals) in writing (and may also provide it orally, if an uninsured (or self-pay) individual requests a good faith estimate in a method other than paper or electronically), upon request or at the time of scheduling health care items and services.  

 You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. 

The estimate should include any associated costs, such as medical tests, prescription drugs, equipment, and hospital fees. 

 Information regarding scheduled items and services must be furnished within 1 business day of scheduling an item or service to be provided in at least 3 business days; and within 3 business days of scheduling an item or service to be provided in at least 10 business days. 

 You can also request that your healthcare provider, and any other provider of your choice, give you a Good Faith Estimate before you schedule an item or service. Make sure you save a copy or picture of your Good Faith Estimate. 

 For medical items or services received on or after January 1, 2022 you may dispute bills $400 higher than your Good Faith Estimate. The dispute must be filed within 120 calendar days after receiving the bill. 

Learn more about the protections that apply to you

 

What Providers and Facilities Are Required to Do :

• Provide a Good Faith Estimate before an item or service is scheduled, within specific time frames.
• Furnish an itemized list of each item or service, grouped by the provider or facility offering care. Each item or service must include certain details, like the health care code assigned to it and the anticipated charge.
• Clearly explain the good faith estimate to you over the phone or in-person if you request it, and then follow up with a written (paper or electronic) estimate.
• Provide the good faith estimate in a way that’s accessible to you.

For more information about your right to a Good Faith Estimate, please visit www.cms.gov/nosurprises.