Good Faith Estimate: Your Right to Know Healthcare Costs Before Treatment

Imagine walking into a restaurant, ordering dinner, eating, and then being handed a bill for $800 with no menu prices to reference. You'd be outraged. Yet that's essentially how healthcare billing worked for decades.

The Good Faith Estimate (GFE) is a federal requirement designed to change that. Under the No Surprises Act, healthcare providers must give you an upfront estimate of costs for scheduled services. It won't eliminate surprise bills entirely, but it's a significant step toward knowing what you'll pay before you receive care.

What Is a Good Faith Estimate?

A Good Faith Estimate is a written document that lists the expected charges for a scheduled healthcare service. It must include:

• Patient information — Your name and date of birth
• A description of each service — What will be done, listed individually
• Diagnosis codes — The expected ICD-10 diagnosis codes
• Service codes — The CPT or HCPCS codes for each expected item
• Expected charges — The anticipated cost for each service
• Provider information — Name, NPI, and Tax ID of each provider involved
• A disclaimer — Noting that actual charges may differ

Key takeaway: The GFE isn't a binding contract — it's an estimate. But it's your baseline. If the final bill exceeds the estimate by more than $400, you have the right to dispute it.

Who Gets a Good Faith Estimate?

The current federal GFE requirement applies primarily to:

• Uninsured patients — Anyone without health insurance coverage
• Self-pay patients — Anyone choosing not to use their insurance for a particular service

The law is expected to expand to include insured patients as well, but as of early 2026, the formal GFE requirement with dispute rights applies to uninsured and self-pay individuals.

However: Even if you have insurance, you can (and should) ask for a cost estimate before any scheduled procedure. Many providers will give you one — they're just not legally required to include the same level of detail or offer the same dispute process.

For insured patients, you can also call your insurance company and ask for a pre-service cost estimate based on your plan benefits. This will factor in your deductible, coinsurance, and network status.

When Should You Receive a GFE?

Providers must give you a Good Faith Estimate:

• When you schedule a service — The estimate should be provided at least 1 business day before a service scheduled 3+ days in advance, or at least 3 business days before a service scheduled 10+ days in advance.
• When you request one — You can request a GFE at any time, and the provider must respond within 3 business days.

In practice, many providers don't proactively provide GFEs unless you ask. Always ask.

How to Request a Good Faith Estimate

Before Scheduling

When you call to schedule a procedure, test, or appointment, say:

"Before I schedule, I'd like a Good Faith Estimate of the total expected cost for this service. I understand this is my right under the No Surprises Act. Can you provide that?"

After Scheduling

If you've already scheduled but haven't received an estimate:

"I have [procedure] scheduled for [date]. I'd like to request a Good Faith Estimate of all expected charges, including any co-providers like anesthesiologists or labs. My account number is [number]."

What to Ask For Specifically

A good GFE should cover all expected costs, including services from other providers involved in your care. Ask:

• "Will there be separate charges from an anesthesiologist?"
• "Are lab or pathology fees included?"
• "Is the facility fee included, or just the physician fee?"
• "What about pre-operative tests or post-operative follow-ups?"

One of the biggest billing surprises is finding out that the surgeon's fee was only one of five bills coming your way. The multiple-bill-for-one-visit problem is real, and a thorough GFE should account for it.

How to Use Your Good Faith Estimate

Compare Prices

Once you have a GFE, compare it with other providers. The same procedure can cost dramatically different amounts at different facilities — sometimes 3–5x more for the exact same service. Use Taven's cost comparison tool to see how the estimate stacks up against other options in your area.

Budget and Plan

Knowing the expected cost lets you plan financially. Can you cover it? Do you need to set up a payment plan? Should you consider a different provider or an outpatient facility instead of a hospital?

Negotiate Before, Not After

It's easier to negotiate costs before receiving care than after. If the estimate seems high, ask about:

• Cash-pay discounts — Often 20–50% less than the standard rate
• Outpatient alternatives — Ambulatory surgery centers are typically much cheaper than hospitals for the same procedures
• Whether all components are necessary — Sometimes tests included in the estimate are optional

See our full negotiation guide for detailed scripts and strategies.

What If Your Bill Exceeds the Estimate?

This is where the GFE has real teeth. If the final bill is more than $400 above the Good Faith Estimate, you can initiate a dispute through the patient-provider dispute resolution (PPDR) process.

How the Dispute Process Works

1. Gather your documents — You'll need your GFE, the final bill, and any other relevant paperwork.
2. Initiate the dispute — File through the CMS dispute resolution portal within 120 calendar days of receiving the bill.
3. Pay a small fee — There's a nominal administrative fee (around $25).
4. Independent review — A third party reviews the GFE, the bill, and any supporting information from both sides.
5. Decision — The reviewer determines a fair payment amount. This decision is binding on the provider.

While the dispute process isn't perfect (it requires effort on your part), the mere existence of this mechanism encourages providers to give accurate estimates.

Limitations of the Good Faith Estimate

The GFE is a useful tool, but be aware of its limits:

• It's an estimate, not a guarantee. Complications during surgery, unexpected findings, or additional tests can change the final bill legitimately.
• Emergency care doesn't apply. You can't get a GFE for an ER visit. (Though the No Surprises Act has other protections for emergency situations.)
• It may not include all providers. In theory, the convening provider should coordinate estimates from other involved providers. In practice, this doesn't always happen.
• Insurance complicates things. If you have insurance, your actual out-of-pocket cost depends on your plan benefits, deductible status, and network status — not just the provider's charges.

Making the Most of Price Transparency

The Good Faith Estimate is one piece of a larger push toward healthcare price transparency. You can also:

• Check hospital price lists — Hospitals are required to publish their prices online. Taven aggregates this data to make comparison easier.
• Use your insurer's cost estimator — Most insurers have online tools that show your expected out-of-pocket cost based on your specific plan.
• Ask about cash-pay prices — Especially for imaging, lab work, and outpatient procedures, the cash price is often lower than the insured price.

The Bottom Line

The Good Faith Estimate is one of the most practical consumer protections in healthcare. It won't solve everything, but it shifts the power dynamic from "pay whatever we bill you" to "here's what to expect — and you can hold us to it."

Your action items:

• ✅ Request a GFE before any scheduled procedure or service
• ✅ Ask for all associated costs (facility, physician, anesthesia, lab, pathology)
• ✅ Compare the estimate with other providers using Taven
• ✅ Save the GFE — you'll need it if the final bill is $400+ higher
• ✅ Dispute through the PPDR process if your bill significantly exceeds the estimate

You have the right to know what care will cost. Use it.