Because psychotherapy is a reoccurring service, you can provide a GFE covering up to a year of services. How you structure your GFE involves a tension between:
- advising patients about the potential high end of fees, which reduces the risk of your actual billing exceeding your GFE; and
- giving patients a more realistic view of costs if treatment goes well and there are not complications.
APA’s GFE template form (DOCX, 26KB) provides an example of how to satisfy both needs. As filled out, that form might essentially tell patients “Until I do an evaluation and we start therapy, I can’t really predict how long therapy will take, but I typically see patients for 8 to 15 sessions. However, some/many of my patients have more complex issues that may require as many as 30 sessions during the time frame of this GFE.”
For new patients, another approach is to do an initial GFE for just the initial evaluation or the first few sessions, and then provide an updated GFE when you have a better picture of the patient’s likely needs.
Timeframe for GFEs: Doing long-term GFEs for patients will mean that you need to generate less GFEs. On the other hand, doing GFEs more frequently (e.g., monthly or quarterly) has several advantages:
- Long-term GFEs reduce the risk that your actual billing will get ahead of an old, outdated GFE.
- Long-term GFEs reduce the risk that long-term or potential long-term patients will be troubled by looking at the higher dollar figure associated with a longer time frame.
A system for easy tracking: If you have many long-term uninsured/self-insured patients, you may want to give new patients an initial GFE, but then set up a regular timeframe for subsequent GFEs (e.g. giving estimates to patients quarterly or every six months). You will need to update GFEs ahead of that schedule if circumstances change for a particular patient that will likely create a significant change in predicted future costs.