Good Faith Estimate (GFE)
Good Faith Estimate
Under the No Surprises Act, the written estimate of expected charges providers must give to uninsured and self-pay patients prior to scheduled services.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Payer
- Acronym for
- Good Faith Estimate
- Primary sources
- 2
- Workspace handoff
- templates →
Where this comes up
Front-office and billing both hit this term — eligibility before the visit, prior auth before the procedure, contract terms during fee-schedule negotiation, and credentialing whenever a new provider joins or a payer roster lapses. Misses here become denials downstream.
Full definition
What it is in practice
CMS GFE is required at the time of scheduling (per regulatory timelines) for uninsured / self-pay patients. The estimate must include the practitioner / facility identifier, service description, and expected charges.
How it shows up in your practice
Build a templated GFE generator into scheduling. Misalignment between estimate and actual charge by $400+ can trigger the patient-provider dispute resolution process.
Sources
- CMS — No Surprises Acthttps://www.cms.gov/nosurprises
- CMS — Good Faith Estimate Guidancehttps://www.cms.gov/regulations-and-guidance/legislation/no-surprises-act/good-faith-estimate
Use the GFE template
Open templates →Related terms
- PayerNo Surprises ActFederal law effective January 1, 2022 that protects patients from surprise medical bills for emergency services, non-emergency services at in-network facilities by out-of-network providers, and air ambulance services.
- PayerPatient-Provider Dispute ResolutionUnder the No Surprises Act, the process by which uninsured or self-pay patients may dispute a bill that exceeds the Good Faith Estimate by $400 or more.
- PayerAdvance Explanation of Benefits (AEOB)Under the No Surprises Act, the advance benefit statement that insurers must provide to insured patients before scheduled services (implementation deferred).
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
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Related across the archive
- GlossaryAdvance Explanation of Benefits (AEOB)Under the No Surprises Act, the advance benefit statement that insurers must provide to insured patients before scheduled services (implementation deferred).
- GlossaryNo Surprises ActFederal law effective January 1, 2022 that protects patients from surprise medical bills for emergency services, non-emergency services at in-network facilities by out-of-network providers, and air ambulance services.
- GlossaryPatient-Provider Dispute ResolutionUnder the No Surprises Act, the process by which uninsured or self-pay patients may dispute a bill that exceeds the Good Faith Estimate by $400 or more.
- GlossaryIndependent Dispute Resolution (IDR)Under the No Surprises Act, the arbitration process for resolving payment disputes between OON providers and payers for protected services.
- GlossarySelf-Pay PatientA patient who pays for healthcare services directly, either because they are uninsured or because they elect to pay without using insurance.
- ComplianceOIG LEIE Monthly Exclusion Screening: Process + Audit-Ready LogsMonthly OIG LEIE and SAM.gov exclusion screening for every workforce member and vendor: the workflow, the log fields auditors require, and the escalation path.
- CompliancePECOS Provider Enrollment Verification (2026) — Quarterly ChecklistQuarterly PECOS provider enrollment verification workflow: who to check, the exact lookup steps, the audit log columns, and the revalidation escalation path.
- Glossary270/271 Eligibility Inquiry/ResponseThe HIPAA standard EDI transactions used to verify patient insurance eligibility (270 query, 271 response).
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.