Good Faith Estimate — Rooted Mosaic Therapy

At Rooted Mosaic Therapy, transparency around fees and billing is part of providing ethical, supportive care. As required under the No Surprises Act (2022), clients who are uninsured or choose to self-pay for services have the legal right to receive a Good Faith Estimate (GFE) of expected charges before treatment begins.

Who This Applies To

‍Colorado clients: This applies to every Colorado client automatically, as I am not credentialed with insurance providers in the state of Colorado. You'll receive a GFE as a standard part of starting care.

Illinois clients: In Illinois, whether you do not have insurance or are opting to not use your insurance and pay privately, you have the same right to a GFE as a standard of care.

What's Included

Your Good Faith Estimate will outline:

  • The anticipated number of sessions and session frequency, based on your treatment plan

  • Session length and fee per session

  • Relevant service codes, and any diagnostic codes that have been determined at the time of the estimate

How to Request One

You can request a Good Faith Estimate before scheduling your first session, during intake, or at any point during our work together. It will be provided in writing and kept as part of your client record. You're welcome to request an additional copy at any time.

Please note: therapy is individualized and needs can change over time. Your GFE is an estimate to support your decision-making, and should not be treated as a contract for a fixed number of sessions.

Your Right to Dispute

If you receive a bill that is $400 or more above the amount listed in your Good Faith Estimate, you have the right to dispute the charge. You can start that process through the official CMS website: cms.gov/nosurprises.

Questions

Please reach out anytime at katie@rootedmosaictherapy.com or (312) 219-4345 if you'd like to request an estimate or have questions about fees.

Rooted Mosaic Therapy 
Katie Catalano, LCSW

Office Location:
213 W Institute Pl Ste 500
Chicago, IL 60610

Telehealth across Illinois and Colorado


Last updated: 8/6/2026