Good Faith Estimate

Clear Mind Therapy PLLC - Good Faith Estimate

Nathaly Moreno, MA, LMFT, CST

Contact: hello@clearmindtherapy.health, 832-301-8218

Texas State License: 203516, NPI: 1619512233

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Last updated: May 15th, 2025

Effective January 1, 2022, a ruling went into effect called the “No Surprises Act,” which requires mental health practitioners to provide a Good Faith Estimate (GFE) about out-of-network care to any client who is uninsured or who is insured but does not plan to use their insurance benefits to pay for health care services.

The Good Faith Estimate is designed to outline the expected cost of mental health services based on what is reasonably known at the time. It helps clients understand potential expenses in advance. The estimate may not include unexpected or additional services that could arise over the course of care.

At Clear Mind Therapy PLLC, I believe in transparency and want you to feel informed and empowered as you begin therapy. While it’s hard to predict exactly how many sessions you may need, the information below provides a clear starting point.

My standard rates for self-pay clients are:

Individual Therapy (50 minutes): $215
Individual Intake Session (80 minutes): $350
Couples Therapy (80 minutes): $400
Couples Intake Session (3 hours): $900
Deep Dive Session (2 hours): $600
Deep Dive Session (3 hours): $900

Session frequency will vary depending on your needs and goals. Many clients attend weekly or biweekly sessions, but this is always a collaborative decision.

Example of Estimated Costs:

Here are a few examples based on common therapy timelines:

$215 individual session x 10 sessions = $2,150
$400 couples session x 10 sessions = $4,000
$600 deep dive session x 4 sessions = $2,400

Your total cost of care will depend on the number of sessions you attend, the duration of those sessions, and the goals you’re working toward.

Important Information and Your Rights

This Good Faith Estimate is not a binding agreement and is meant to help you understand your financial responsibility.
You can pause or end therapy at any time.
If I provide additional services like reports or letters, they may have additional fees as outlined in your consent paperwork.
You may request a revised estimate at any time.
If the actual charges exceed this estimate by more than $400, you have the right to dispute the bill.
To learn more or file a dispute, visit www.cms.gov/nosurprises or call 1-800-985-3059.

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