Your Rights Under the No Surprises Act

Information for Physical Therapy Patients
Effective January 1, 2022, the federal No Surprises Act protects patients from unexpected medical bills. This law applies to physical therapy services.

What Is “Surprise Billing”?
A surprise bill is an unexpected charge you may receive when you didn’t know or agree to the cost of care ahead of time.
The No Surprises Act helps protect you from these situations.

Your Key Rights as a Patient
1. Protection from Surprise Bills
You are protected from surprise billing when:

• You receive emergency care

• You receive non-emergency care from an out-of-network provider at an in-network facility

For these situations, you cannot be charged more than your in-network cost-sharing (copay, coinsurance, deductible).

2. Good Faith Estimate (If You’re Uninsured or Self-Pay)
If you do not have insurance or choose not to use your insurance, you have the right to receive a Good Faith Estimate of expected charges before your physical therapy services begin.
This estimate will include:

• Expected costs for physical therapy services

• Any related services reasonably expected as part of your care

You may request a Good Faith Estimate at any time.

3. Bill Dispute Rights
If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill through a federal patient-provider dispute resolution process. 

You must start the dispute within 120 days of receiving the bill.

What This Means at Our Physical Therapy Clinic

• We will explain your financial responsibility as clearly as possible

• We will provide a Good Faith Estimate when required

• We encourage you to ask questions about costs before starting care

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Questions or Concerns?
If you have questions about your bill or estimate, please contact our office directly.

For more information about your rights under the No Surprises Act, visit:
www.cms.gov/nosurprises
Or call 1-800-985-3059