Important Disclaimers

1. This Good Faith Estimate (GFE) is not a contract or a bill. You may decline services at any time.

2. If you receive a bill that is ≥ $400 above this estimate, you have the right to dispute the charge through the HHS patient-provider dispute process.

3. Prices are valid for 12 months from the date you receive this GFE.

4. Insurance may cover part of your care. If you intend to use insurance, ask for a pre-authorization quote first.

   What’s Included

   • Board-Certified Clinician Oversight – clinical taper protocol based on evidence-based guidelines.

   • Dose-by-Dose Conversion Chart tailored to the benzodiazepine you’re taking (e.g., Ativan®, Xanax®, Valium®).

   • 24/7 Secure Portal Messaging for non-emergency questions between visits.

   • Digital Symptom Tracker to monitor CIWA-B scores and withdrawal indicators.

   • What’s Not Included

   • Anything not explicitly listed, like insurance co-pays for medications.

     Estimated Cost Breakdown — Benzodiazepine Taper Program

   • Online Support-Group Access (optional, monthly): Free

   • 1-on-1 In-session Benzo Taper Coaching and Symptom Check-In: Free

   • Personalized Dose-Conversion & Taper Schedule (digital PDF): Free

   • Digital Symptom Tracker to monitor CIWA-B scores and withdrawal indicators: Free

   • Board-Certified Clinician Oversight – clinical taper protocol based on evidence-based guidelines with support medications as needed: included in Office Visit Price

   • Initial Comprehensive Evaluation & Good-Faith Taper Plan: CPT 99205 (90 min): $350

   • Follow-Up Medication-Management Sessions: CPT 99214: Every 3 months if stable: $250

   • Optional comfort medication (Campral-Acamprosate) if not covered by insurance, Amazon, or Cost Plus Drugs: $45-$62 for a 3-month supply ($15-$21 a month)

   • Need to Use Your Insurance? Ask Us for a Superbill

     Although OffBenzos operates mainly as a self-pay practice, we do take some insurance on specific days and make it easy to pursue out-of-network reimbursement. After each visit, we can generate a detailed superbill—an itemized receipt that lists your CPT service codes, diagnosis codes, provider credentials, and payment information. Our EHR makes it easy to submit the superbill to your insurance carrier (you upload it to our member portal), and they request reimbursement according to your plan’s out-of-network benefits. Depending on their policy, many clients receive 50–80 % of their costs back. If your insurer requires additional documentation, please let us know, and we’ll provide the supporting paperwork at no extra charge.