Good Faith Estimate

Insurance Accepted:

  • Aetna
  • AmeriHealth 
  • BlueCross/BlueShield
  • Clover Medicare
  • Humana TRICARE

Our session fee for self-pay clients is $175. We are able to provide insurance receipts.

Good Faith Estimate

The Good Faith Estimate is a law under the No Surprise Act that became effective January 1, 2022. It requires providers to provide their self-pay potential clients with a written estimate of what their costs will be, as well as verbally informing their clients of such cost. The potential client is required to sign an agreement stating that they were informed of such costs prior to receiving services.  The goal of this new regulation is designed to provide self pay potential clients transparency regarding their expected medical expenses and to protect them from surprises when they receive their medical bills. 

Who qualifies as a self-pay client?

A self-pay client is a person who is uninsured (not enrolled in any health plans and does not have any insurance coverage) or who is electing not to use their health care insurance for services rendered (electing not to file a claim with their insurance carrier).   

Therapy is a little different than other services due to the fact that it is very challenging to provide an estimate of how long services may take as there are many different variables that could change the length of treatment and needs of the client over time.  When addressing issues such as anxiety, depression, family issues, etc. there are many different factors that make it impossible to guarantee how many sessions would be needed.  Overall, as the client, it is your decision when to stop therapy.  This document is to comply with new requirements and provide you with all of the proper information. 

Frequency of Treatment:

The frequency of treatment is based on the potential client’s needs. Some clients require meeting weekly, while others might require meeting less frequently such as every other week. The frequency of when the potential client will meet with this clinician will be discussed at the end of the initial session and throughout treatment. Some clients need to meet briefly for only a few sessions while others may need treatment for more than a year. Below is a total estimated cost for a client who needs a full year of therapy.

Good Faith Estimate Cost:

Therapy Sessions: $175

Weekly sessions for 50 weeks in a year: $8,750

Every other week sessions for 50 weeks in a year: $4,375

Every 4 week sessions for 50 weeks in a year: $2,100

Common Service Codes:

90791- Psychotherapy intake and initial consult

90837- Psychotherapy, 60 min, individual session 

Provider Information:

Provider/facility: Family First LLC

National Provider Identifier (NPI): 1245445212 

Taxpayer Identification Number (TIN): 20-2349105

Addresses where services will be provided in person: 

14 Farber Road, Princeton, NJ 08540

109 Mercer Street, Hightstown NJ 08520

2 Clerico Lane, Hillsborough NJ 08821

Contact Information:

Contact person: Laura Moss

Phone Number: (732) 979-2230

Email: laura@familyfirstnj.com

Additional Notes:

The Good Faith Estimates listed above are estimates and not final overall total charges.  This estimate does not include unexpected or unknown costs that could arise throughout the treatment period.  If needed, recommendations will be discussed with the client during the course of treatment. A diagnosis with a diagnosis code will be provided to the client at the end of the initial session. Total charges at the end of services may differ. 

We have a 48 hour cancellation policy.  If you do not cancel or reschedule 48 hours prior to your session you will be charged $50. Some clients may be paying a different rate from what is listed above and those rates will not change.  This estimate is not a contract and does not require the client to obtain the items or services from any of the providers at Family First LLC.

The client has a right to initiate a patient-provider dispute resolution process (PPDR) should the client feel that the actual bill is at least $400 higher than the agreed upon estimated charges. For more information regarding PDR or regarding the Good Faith Estimate proceed to http://www.cmc.gov/nosurprises or call 1(800) 368-1019.