Good Faith Estimate

This Good Faith Estimate outlines the reasonably anticipated costs of art therapy/psychotherapy services based on the information available at the time this estimate is provided.

This estimate is not a contract and does not require you to obtain services from Lindsay Downs or The 3 Brushes, LLC.

This is not the official Good Faith Estimate form, but this form does include information and cost estimates that are typically included in a GFE.

Under the No Surprises Act, you have the right to receive a Good Faith Estimate explaining the expected costs of healthcare services provided to you.

Art therapy/psychotherapy is individualized, so it may not be possible to determine in advance the exact number of sessions or total cost of treatment for any specific person.

This estimate is intended to provide a general overview of anticipated art therapy . psychotherapy service costs. The total cost of care will depend on factors such as the frequency of sessions, individual treatment needs, and the types of services provided throughout treatment.

Additional services may occasionally be recommended as part of your care that are not included in this estimate and may need to be scheduled separately.

This Good Faith Estimate only reflects the services specifically identified within this document.

About Good Faith Estimates

You have the right to initiate a dispute resolution process if the actual charges substantially exceed the estimated costs listed in your Good Faith Estimate by $400 or more. For additional information about your rights under the No Surprises Act or the dispute resolution process, please visit:

CMS No Surprises Act Information

OR

Call 1-800-985-3059

Initiating a dispute resolution process will not negatively affect the quality or availability of services provided to you.

Please note that the intake evaluation, also referred to as the initial assessment or diagnostic evaluation, is billed one time at a rate of $200.

Ongoing psychotherapy sessions are billed according to the current session rates outlined in this estimate.

Parent, Caregiver, and Legal Guardian Sessions

Separate sessions with a parent, caregiver, or legal guardian may occasionally be recommended as part of the therapeutic process, particularly when working with children and teens.

These sessions may provide an opportunity to discuss treatment goals, strengthen support strategies, address concerns, and collaborate around the child’s or teen’s therapeutic needs.

The frequency and duration of these sessions will depend on clinical needs and treatment goals.

If a separate session is recommended, I will discuss its purpose, scheduling, and applicable fee with you in advance. The need for these sessions may vary throughout treatment, anticipated charges will be reflected in the applicable Good Faith Estimate or addressed through an updated or separate estimate when appropriate.

SESSION FREQUENCY

Session frequency is typically weekly or biweekly, though treatment recommendations may vary depending on your clinical needs and goals.

It is expected that art therapy has a beginning and an end so sessions that start weekly will likely go biweekly then monthly or sessions will end depending on treatment needs as well as established goals and outcomes.

COST ESTIMATES

The fee tables below provide estimated costs based on common treatment intervals over the course of a calendar year:

First Session | Initial Diagnostic Evaluation = $200 (one-time standalone fee)

The initial diagnostic evaluation is a separate first appointment designed to review clinical history, current concerns, goals and outcomes for art therapy, and determine whether art therapy services are an appropriate fit.

Ongoing Sessions

  • Daytime appointments (1:00 PM–3:00 PM): $125 per 53-60 minute session

  • Evening appointments (4:00 PM–8:00 PM): $150 per 53-60 minute session

Estimated Annual Investment for Ongoing Sessions

  • Weekly sessions (52 sessions/year): $6,500–$7,800

  • Biweekly sessions (26 sessions/year): $3,250–$3,900

  • Twice weekly sessions (104 sessions/year): $13,000–$15,600

  • Monthly sessions (12 sessions/year): $1,500–$1,800

Actual costs may vary depending on appointment frequency and scheduling availability.

Monthly sessions are typically offered for established clients who have developed a therapeutic foundation and are transitioning to less frequent appointments. These sessions provide continued consistency, support, and opportunities for reflection while maintaining connection and progress over time.

Estimated Investment for Ongoing Individual Art Therapy Sessions

Based on appointment frequency and scheduling availability, ongoing session investment may range as follows:

  • 1 Month (4 sessions): $500–$600

  • 3 Months (12 sessions): $1,500–$1,800

  • 6 Months (24 sessions): $3,000–$3,600

  • 9 Months (36 sessions): $4,500–$5,400

  • 12 Months (52 sessions): $6,500–$7,800

Actual investment varies depending on session frequency and whether appointments are scheduled during daytime or evening availability.

About Good Faith Estimate

This Good Faith Estimate is not intended to serve as a recommendation for treatment or a prediction that you may need to attend a specified number of psychotherapy visits. The number of visits that are appropriate in your case, and the estimated cost for those services depends on your needs and what you agree to in a consultation with your therapist or the initial session. 

You can disagree with any recommendations made to you concerning your treatment, and you may discontinue treatment at any time. Art therapy is voluntary and discussions regarding treatment are highly recommended so treatment is tailored to your needs or the appropriate referral is given.

You are encouraged to speak with your provider at any time about any questions you may have regarding your treatment or the information provided to you in this Good Faith Estimate.

Upon your request, or in the case of a crisis, additional services may be required or requested by you. The list of all services and fees is part of your informed consent form.

Separate good-faith estimates will be issued upon request and added to your secure client portal upon establishing and confirming for treatment and art therapy services. 

If there is an update to the charges for services, this practice will provide you with 30 days’ notice of the change of fee and provide options regarding continuing, transferring, or discontinuing services.

There may be additional items or services your provider recommends as part of psychotherapy that must be scheduled or requested separately not reflected in the Good Faith Estimate; The information provided in the good faith estimate is only an estimate regarding items or services reasonably expected to be furnished at the time the Good Faith Estimate is issued to the uninsured (or private pay / self-pay) individual and that actual item, services, diagnosis or charges may differ from the Good Faith Estimate.

You have the right to initiate the client-provider dispute resolution process if the actual billed charges are substantially in excess of the expected charges included in the Good Faith Estimate, as specified in § 149.620; this disclaimer must include instructions for where an uninsured (or private pay/ self-pay) individual can find information about how to initiate the patient-provider dispute resolution process and state that the initiation of the patient-provider dispute resolution process will not adversely affect the quality of health care services furnished to an uninsured (or private pay/ self-pay) individual by a provider or facility.

This Good Faith Estimate is not a contract and does not require you to obtain the items or services from any of the providers or facilities identified in the good faith estimate.

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.

Under the law, health care providers need to give clients/patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including art therapy / psychotherapy services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.

You can ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service or receive treatment.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

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