No Surprises Act · 45 CFR 149.610
Good Faith Estimate
You have the right to receive a Good Faith Estimate explaining how much your care will cost. Federal law requires health care providers to give an estimate of expected charges to anyone who is uninsured, or who has insurance but is not asking us to submit a claim to their plan. Bliss Progressive Psychiatry, PLLC does not bill health insurance, so this applies to everyone we serve.
Your right to a Good Faith Estimate
A Good Faith Estimate of expected charges is available to you when you schedule care with us, and at any time upon request. Ask us in the office, by phone at 502-888-1494, by email at info@blisspsych.com, or through the Spruce messaging system, and we will provide one in writing.
This page explains what our Good Faith Estimates cover and shows the rates they are built from. It is not itself an estimate. Every client receives their own written Good Faith Estimate covering the care we expect to provide.
If your care is expected to continue past the end of the period covered, or if the frequency, duration, or expected charges change, we will issue you a new Good Faith Estimate and explain what has changed.
1. Provider information
- Practice
- Bliss Progressive Psychiatry, PLLC
- Provider
- Amanda Bliss, MSN, APRN, FNP-BC, PMHNP-BC
- National Provider Identifier (NPI)
- 1225201288
- Tax Identification Number (TIN)
- 93-3291118
- Location of services
- 159 St. Matthews Avenue, Suite 8, Louisville, Kentucky 40207
- State where services are furnished
- Kentucky
- Contact person for this estimate
- Amanda Bliss, APRN
- Phone
- 502-888-1494
- info@blisspsych.com
2. Expected scope of care
A single estimate covers recurring services over a defined period. Federal law allows one estimate to cover recurring care for up to twelve months, provided the expected scope is stated clearly.
- Period of care covered
- One year from the date the estimate is issued
- Expected frequency
- Medication management visits are most often scheduled every one to three months, more often at the beginning of treatment and during periods of acuity, and sometimes less often.
- Expected total number of visits
- Up to 1 initial visit plus 12 follow-up visits over 12 months. If ketamine is part of your care, up to 7 ketamine treatments.
Unless it was specifically discussed during a prior visit, we do not make changes to medications outside of scheduled appointments.
This is one reason follow-up visits are scheduled at the intervals above. Refills of a medication you are already taking, at the dose you are already taking, are processed without an appointment.
3. Itemized estimate of expected charges
Psychiatric care
The frequency and type of visits appropriate in your case depend on your needs and goals, and cannot be known before your first visit. The three patterns below cover the range we see in practice. Because we cannot know in advance which will fit you, an estimate is issued at the highest of the three.
| Visit | Stable, roughly quarterly | Typical, every 6 to 8 weeks | Active, roughly monthly |
|---|---|---|---|
| Initial visit / psychiatric evaluation, 90 minutes, at $400 | 1 visit · $400 | 1 visit · $400 | 1 visit · $400 |
| Extended follow-up medication management, 45 minutes, at $240 | 4 visits · $960 | 8 visits · $1,920 | 12 visits · $2,880 |
| Total at these rates over 12 months | $1,360 | $2,320 | $3,280 |
Rates shown are effective October 1, 2026.
How this becomes your estimate
Your written estimate is issued at the highest of the three patterns above. Most clients are seen less often than that and pay considerably less, because you are charged only for the visits you actually attend.
These figures cover psychiatric care only. Ketamine treatment is estimated separately below.
Other services expected during the period are added as their own line, such as a 30-minute follow-up at $180 or time outside of scheduled appointments at $30 per 5-minute increment.
If a discount applies to you, such as the veteran discount, your estimate reflects the discounted rates rather than the standard rates above. Federal law requires expected charges to reflect any discount you will receive.
Ketamine treatment
Ketamine is not part of every client's care. Whether it is appropriate for you is decided with your provider, usually after your initial evaluation. The figures below apply only if ketamine becomes part of your plan.
Courses of ketamine treatment are tailored to the individual, and the number of treatments and the intervals between them vary considerably from one client to another. The estimate below is based on the range we see in practice.
| Item or service | Rate | Treatments | Expected charge |
|---|---|---|---|
| Ketamine treatment | $415 | up to 7 | $2,905 |
| Ketamine treatment, Saturday | $525 | as scheduled | billed at $525 each |
| Total at these rates over 12 months | $2,905 |
Rates shown are effective October 1, 2026.
If ketamine becomes part of your plan after your estimate is issued, that is a change in the expected scope of your care, and you will receive a new Good Faith Estimate at that time.
Saturday treatments are billed at $525 rather than $415. If Saturday treatments are expected in your case, your estimate will be higher.
4. Services that require separate scheduling
Separate Good Faith Estimates are issued when the items or services listed below are scheduled, or upon your request. For those items and services, information such as expected charges and provider identifiers is not included in your main estimate, because that information is provided in the separate Good Faith Estimate you receive when the service is scheduled or requested.
- Laboratory testing ordered as part of your care and performed by an outside laboratory
- Prescription medications dispensed by an outside or compounding pharmacy, including sublingual ketamine
- Care from any other provider or facility to whom you are referred
To request a Good Faith Estimate for any item or service on this list at any time, contact us at info@blisspsych.com or through the Spruce messaging system.
5. Required disclaimers
This estimate is not a treatment recommendation
A Good Faith Estimate is not a recommendation for treatment, and it is not a prediction that you will need a specified number of visits. The number of visits appropriate in your case depends on your needs and on what you agree to in consultation with your provider. You are entitled to disagree with any recommendation made to you concerning your treatment, and you may discontinue treatment at any time.
This estimate may not include everything we recommend
There may be additional items or services that Bliss Progressive Psychiatry recommends as part of your course of care that must be scheduled or requested separately. Those items and services are not reflected in your Good Faith Estimate.
This is an estimate, not a bill
The information in a Good Faith Estimate is only an estimate of the items and services reasonably expected to be furnished at the time the estimate was issued. The actual items, services, or charges may differ from the Good Faith Estimate.
This estimate is not a contract
A Good Faith Estimate is not a contract. It does not require you to obtain any of the items or services from Bliss Progressive Psychiatry, PLLC or from any other provider or facility identified in the estimate. You do not need to sign it.
Your right to dispute a bill
If you are billed at least $400 more than your Good Faith Estimate, you have the right to dispute the bill. You may start a patient-provider dispute resolution process with the U.S. Department of Health and Human Services. You must start the dispute process within 120 calendar days of the date on your original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will pay the price on your Good Faith Estimate. If the agency agrees with the provider, you will pay the higher amount.
You may also contact us first to let us know the billed charges are higher than your Good Faith Estimate. You can ask us to update the bill to match the estimate, ask to negotiate the bill, or ask whether financial assistance is available. That is an invitation, not a requirement, and it does not affect your right to use the dispute process.
Instructions for starting the dispute process are available at www.cms.gov/nosurprises or by calling the No Surprises Help Desk at 1-800-985-3059.
Starting a dispute will not affect the quality of the health care services furnished to you by Bliss Progressive Psychiatry, PLLC. We will not retaliate against you in any way for using this process.
6. Questions and where to get help
For questions about your estimate, contact us at info@blisspsych.com or through the Spruce messaging system.
For questions about your rights under the No Surprises Act:
No Surprises Help Desk
Kentucky Department of Insurance
Division of Consumer Protection
800-595-6053, option 1 (Kentucky only)
502-564-6034
A copy of your Good Faith Estimate is kept as part of your medical record. You may request a copy of any Good Faith Estimate we have issued to you within the last six years at any time, at no charge.