State whether you plan to use insurance
CMS explains good faith estimates for people who do not have insurance or are not using it to pay for care. The estimate lists expected charges; it is not a bill. Tell the practice which payment arrangement you are asking about and request the estimate in writing.
If you are also comparing an insured option, keep that inquiry separate and ask the plan and practice about the expected patient responsibility. Do not compare an insurance premium, a practice’s full charge, and a self-pay estimate as if they describe the same expense. Label each amount with what it actually represents.
Give each practice the same administrative request
Write down the service you are trying to arrange, whether it is an initial or follow-up visit, the proposed format, and the clinician if known. Ask what the estimate includes and what remains unknown before an evaluation. Do not invent a treatment frequency to force a total; ask the clinician what can reasonably be anticipated.
A reusable request is: “I am considering paying without insurance for this appointment. Please explain the written estimate, the services it covers, and any separate charges I should ask about.” Keep the response date and the contact office. If two estimates cover different services, ask for clarification before comparing totals.
Sources: CMS: What is a good faith estimate?
Check whether another provider or facility needs a separate estimate
CMS says good faith estimates currently list expected charges for a single provider or facility. Care involving more than one provider can require separate requests. CMS also explains that an estimate may not include unanticipated care or services that will be provided elsewhere.
For mental health care, ask whether the quote is for therapy, a psychiatric evaluation, or another named service. If different offices are involved, give each its own row. Ask whether paperwork fees, missed-appointment charges, or other administrative policies are addressed separately; do not assume they are included in the clinical service estimate.
Sources: CMS: What is a good faith estimate?
Compare assumptions and keep the written result
Create a simple comparison with the provider, service, visit format, amount, number of visits described, time period, and items left unresolved. Mark an unknown item as unknown. A blank field is a question for the office, not evidence that the item is free. Ask for an updated explanation if the planned service changes.
Keep the written estimate so you can compare it with the eventual bill. CMS provides guidance on asking billing questions and on the process for certain bills that substantially exceed an estimate. If a bill differs, start by identifying the provider, service, and line item involved, then use the official CMS guidance to understand the applicable next steps.
Sources: CMS: Medical bill rights when not using insurance; CMS: What is a good faith estimate?
Your next-step checklist
- State whether the request is self-pay or insurance-based.
- Use the same appointment description for each estimate request.
- Identify the clinician, service, and visit format.
- Ask whether another provider requires a separate estimate.
- Record exclusions and unknown items without assuming they cost nothing.
- Save the written estimate and compare it with the bill.
Keep personal, insurance and medical information in the appropriate organization’s approved secure channel.
Common questions
Is a good faith estimate a final bill or a guaranteed treatment plan?
No. CMS describes it as expected charges before care. Ask what services and assumptions it covers, including anything that remains unknown or would be provided separately.
Sources: CMS: What is a good faith estimate?; CMS: Medical bill rights when not using insurance
Do I need to ask each clinician if therapy and psychiatry are in different practices?
CMS advises requesting estimates from each provider or facility involved. Ask each practice what its estimate covers so you can compare complete, clearly labelled information.
Sources: CMS: What is a good faith estimate?
Sources and verification
The sources below support the administrative information in this guide. Follow the responsible organization’s current instructions when requirements, forms or contact routes change.
- CMS: What is a good faith estimate? — checked .
- CMS: Medical bill rights when not using insurance — checked .