Good Faith Estimate Generator

Create a No Surprises Act-compliant Good Faith Estimate in minutes. Enter your practice details, add services with CPT codes, and generate a properly formatted GFE — ready to print or share with patients.

What Is a Good Faith Estimate?

A Good Faith Estimate (GFE) is a written document that itemizes the expected costs of healthcare services for uninsured or self-pay patients. Required under the No Surprises Act (effective January 1, 2022), the GFE gives patients price transparency before they receive care — and legal recourse if the final bill significantly exceeds the estimate.

The regulatory requirements are codified at 45 CFR § 149.610. Every state-licensed or certified healthcare provider and facility must comply, including physicians, therapists, dentists, chiropractors, and labs. Unlike the HIPAA authorization process, which protects patient privacy, the GFE protects patients from unexpected financial burden.

When Is a Good Faith Estimate Required?

Uninsured patients

Any patient who does not have health insurance coverage for the items or services being scheduled.

Self-pay patients

Insured patients who choose not to submit a claim to their insurance and will pay out of pocket.

Upon patient request

Any uninsured or self-pay individual may request a GFE at any time — even before scheduling.

The GFE requirement applies to all non-emergency services. Providers must also post a notice about GFE availability in their office and on their website. For practices that serve both insured and self-pay patients, tracking compliance requirements alongside GFE obligations is essential.

GFE Timing Requirements

The No Surprises Act specifies strict deadlines for providing the estimate based on when the service is scheduled:

Scheduling ScenarioGFE Deadline
Service scheduled 10+ business days in advanceWithin 3 business days of scheduling
Service scheduled 3-9 business days in advanceWithin 1 business day of scheduling
Service scheduled < 3 business days in advanceNo later than the date of service (best practice: provide at time of scheduling)
Patient requests a GFE (no service scheduled)Within 3 business days of the request

Practical tip: Build GFE generation into your scheduling workflow. Many practices provide the estimate at the time of scheduling, regardless of lead time, to avoid missed deadlines. Include a copy in your patient intake packet.

How to Use This Good Faith Estimate Generator

  1. 1

    Enter your practice informationProvider name, NPI, EIN, address, and specialty. This identifies the convening or co-provider on the estimate.

  2. 2

    Add patient detailsName, date of birth, address, and phone number. Required for proper identification on the GFE.

  3. 3

    Set estimate and service datesThe date the estimate is prepared, expected service date, and when the estimate expires.

  4. 4

    Add service lines with CPT codesEnter each expected service with its CPT/HCPCS code, diagnosis code, quantity, and expected charge. Use the quick-select dropdown for common codes.

  5. 5

    Print or copy the estimateThe formatted GFE appears below the builder. Print it, provide it to the patient in paper or electronic form, and retain a copy in your records.

Important: This tool generates a template for informational purposes. Always verify your charges against your current fee schedule. For legal review of your GFE process, consult with a healthcare attorney.

Required GFE Data Elements

CMS specifies the data elements every Good Faith Estimate must include. Missing any element exposes your practice to enforcement risk. This generator includes all of them automatically.

ElementRegulation
Provider name & NPI45 CFR § 149.610(c)(1)
Provider Tax ID (EIN)45 CFR § 149.610(c)(2)
Patient name & DOB45 CFR § 149.610(c)(3)
Service description & codes45 CFR § 149.610(c)(4)
Diagnosis codes (if applicable)45 CFR § 149.610(c)(5)
Expected charges per item45 CFR § 149.610(c)(6)
Service location45 CFR § 149.610(c)(7)
Disclaimer language45 CFR § 149.610(c)(8)
Dispute rights notice45 CFR § 149.610(c)(9)

Service codes must use CPT, HCPCS, DRG, or NDC codes. Credentialed providers should use their enrolled NPI number to ensure consistency across documents.

The $400 Dispute Rule

One of the most important patient rights under the No Surprises Act: if a patient's final bill exceeds the Good Faith Estimate by $400 or more, they can initiate the patient-provider dispute resolution (PPDR) process.

1

Receive a bill at least $400 higher than the GFE

2

Contact the provider within 120 calendar days of the bill

3

File a dispute through the HHS patient-provider dispute resolution portal

4

An independent reviewer determines the appropriate payment amount

5

The decision is binding on the provider (not the patient)

Provider risk: If the dispute ruling favors the patient, the provider must accept the lower amount. Accurate GFEs are not just a compliance obligation — they're financial protection for your practice. Track your estimates alongside your risk assessment process.

Good Faith Estimates for Mental Health Providers

Mental health providers — therapists, psychologists, psychiatrists, and counselors — were among the most affected by GFE requirements because many of their patients pay out of pocket. The nature of therapy (ongoing, variable duration) makes cost estimation particularly challenging.

Recurring Sessions

Estimate the number of sessions expected over the next 12 months. For weekly therapy, a common estimate is 48-52 sessions at your per-session rate.

Variable Session Length

List each session type separately (45-minute vs. 60-minute, individual vs. family) with distinct CPT codes and charges.

Assessment Sessions

Include diagnostic evaluations (CPT 90791) and psychological testing separately from treatment sessions.

Update Obligations

If treatment plans change (e.g., adding EMDR or group therapy), provide an updated GFE. Keep copies with your informed consent documentation.

For more on documentation requirements specific to behavioral health settings, see our guide on the HIPAA minimum necessary rule and how it applies to mental health records. Practices using the Notice of Privacy Practices should reference GFE availability in their patient-facing documents.

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