Good Faith Estimate

Estimated Cost of Services

This estimate outlines the anticipated costs for services provided by The Primary OT.

 

Description of Occupational Therapy Services

• Evaluation: $150

• Therapy Session (Individual): $100 per session

 

Additional Items of Services

• Additional services may be recommended as part of your care plan, but they are not included in this estimate and will require separate scheduling.

• If your care plan changes, you will receive an updated Good Faith Estimate at least one (1) business day before changes take effect.

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Disclaimers

This Good Faith Estimate provides an approximate cost of services based on the information available at the time of issue. Actual costs may vary based on medical necessity, duration of treatment, or changes to your care plan.  There may be additional items or services recommended that are not included in this estimate.

 

If the final charges exceed this estimate by $400 or more, you have the right to initiate a patient-provider dispute resolution process through the U.S. Department of Health & Human Services (HHS). You can learn more at: https://www.cms.gov/nosurprises.