How To Write Good Faith Estimates: A Clinical Documentation Guide for Mental Health Professionals

Good Faith Estimates (GFEs) are an essential part of transparent healthcare communication, especially following the No Surprises Act regulations. For mental health clinicians—including therapists, psychologists, counselors, and social workers—knowing how to prepare clear, accurate GFEs is vital to ensure clients understand anticipated costs before services are rendered. This guide provides practical steps and clinical documentation tips to help you create compliant and client-centered GFEs using Microsoft Word.

Understanding Good Faith Estimates in Mental Health Care

A Good Faith Estimate is a written projection of the expected charges for mental health services, provided to uninsured clients or those scheduling services without insurance coverage. Under federal law, providers must offer GFEs upon request or when scheduling services for clients without coverage.

Key components of a GFE include:

Description of services (e.g., individual psychotherapy, psychological testing)
Anticipated number of sessions or hours
Fees for each service or session
Total estimated cost
Provider and practice information
Date of estimate and disclaimers about potential changes

For mental health clinicians, the GFE serves both as an ethical communication tool and a legal document that supports informed consent regarding financial obligations.

Step 1: Gather Accurate Clinical and Financial Information

Before drafting the GFE, collect all relevant clinical and billing details:

Service codes: Use CPT codes relevant to mental health services (e.g., 90834 for 45-minute individual psychotherapy).
Session length and frequency: Clarify typical session durations (e.g., 50 minutes) and recommended number of sessions based on clinical assessment.
Fee schedule: Reference your current fee schedule, including sliding scale adjustments if applicable.
Additional charges: Include fees for psychological testing, reports, telehealth service fees, or no-show/cancellation policies.

Example:
For a client requesting individual therapy, you might list:

CPT 90834 Individual psychotherapy, 45 minutes — $150/session
Estimated 12 sessions — $1,800 total

Step 2: Use Clear, Professional Language and Formatting in Microsoft Word

Your GFE should be easy to read and professionally formatted. Using Microsoft Word, follow these tips:

Use tables: Insert a simple table to organize service descriptions, CPT codes, unit cost, quantity, and total cost.
Headings and subheadings: Use Heading styles to create a clear hierarchy (e.g., “Service Description,” “Estimated Fees”).
Consistent fonts and spacing: Use a clean, professional font like Calibri or Times New Roman, 11-12 pt, with appropriate spacing.
Include your practice header: Add your practice name, provider credentials (e.g., LCSW, PhD), address, phone number, and email.
Date and client information: Include the date the estimate was prepared and the client’s name or identifier.

Sample table structure:

Service Description	CPT Code	Unit Cost	Quantity	Total Cost
Individual Psychotherapy	90834	$150	12	$1,800
Psychological Testing (optional)	96101	$300	1	$300
Total Estimated Cost				$2,100

Step 3: Include Required Legal and Informational Disclaimers

Federal regulations require certain disclaimers to be included in GFEs to clarify that the estimate is not a guarantee and that costs may change:

Statement of estimate nature:
“This Good Faith Estimate reflects our best estimate of the costs for the services listed based on the information available at this time. Actual charges may vary depending on clinical needs or treatment changes.”
Client rights notice:
“If you receive a bill that is substantially higher than this estimate, you have the right to dispute the charges.”
Contact information:
Provide a clear contact person or office for fee inquiries or disputes.

Place these disclaimers at the bottom of the document, clearly separated from the fee schedule.

Step 4: Tailor Estimates Based on Clinical Complexity and Treatment Planning

Mental health treatment plans frequently evolve, so GFEs must be flexible yet informative. To document effectively:

Provide ranges when appropriate: If treatment length may vary, offer a range of sessions with corresponding costs.
Example: “Estimated 8-12 sessions of individual psychotherapy, $1,200–$1,800.”
Explain clinical variables: Briefly note factors that may affect costs, such as crisis intervention sessions, additional assessments, or coordination with other providers.
Update estimates as needed: If treatment plans change, revise and resend the GFE to maintain transparency.

Step 5: Save and Manage GFEs Efficiently in Microsoft Word

For efficiency and compliance:

Use templates: Create a reusable GFE template in Word with placeholders for client name, date, service details, and fees. This reduces errors and saves time.
Save with descriptive filenames: Use client initials and date (e.g., “GFE_JD_2024-06-15.docx”) for easy retrieval.
Maintain confidentiality: Store GFEs securely according to HIPAA guidelines. Avoid including sensitive clinical details beyond what is necessary for the estimate.
Export to PDF: Before sending to clients, save the GFE as a PDF to preserve formatting and prevent unintentional edits.

FAQ

Q1: When must I provide a Good Faith Estimate?
A: GFEs must be provided upon request by uninsured or self-pay clients, or when scheduling services without insurance coverage. It is best practice to offer GFEs proactively to promote transparency.

Q2: Can I charge for providing a Good Faith Estimate?
A: No. The Good Faith Estimate must be provided free of charge.

Q3: What if the client’s treatment needs change and costs increase?
A: You should provide an updated GFE reflecting the new estimated costs. Document the reason for the change and communicate clearly with the client.

By following these steps, mental health clinicians can produce clear, compliant Good Faith Estimates that support informed client decisions and foster trust in the therapeutic relationship. Using Microsoft Word’s tools effectively ensures your estimates look professional and are easy to update, helping you manage administrative duties efficiently while adhering to regulatory requirements.

How To Write Good Faith Estimates