5.4 Required Disclosures at the Outset: Licensure Status, Fees & Good Faith Estimates

5.4 Required Disclosures at the Outset: Licensure Status, Fees & Good Faith Estimates

Exam Focus: Task 1 opens the entire outline — "disclose professional information required under law to facilitate clients' ability to make treatment decisions." Its three knowledge statements are laws regarding counseling-related disclosures that must be provided to clients (K1), disclosure of licensure or registration status (K2), and disclosure of fees and good faith estimates (K3).

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Three Layers of Disclosure

California counselors operate under three overlapping disclosure regimes, and the exam expects candidates to keep them straight:

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Licensure and Registration Status (K2)

BPC § 4999.30 restricts the title "Licensed Professional Clinical Counselor," "LPCC," and any words or abbreviations implying licensure to persons holding a valid license. BPC § 4999.70 governs display of the license.

BPC § 4999.71 requires the notice to consumers: clients must be told that the Board of Behavioral Sciences, within the Department of Consumer Affairs, receives and responds to questions and complaints about the practice of professional clinical counseling, along with the Board's contact information. In practice this notice appears in the informed consent packet and is commonly posted in the office.

Associates. BBS advertising rules require that an associate's advertising and professional identification state the registration title, the registration number, and the name of the supervisor. The purpose is consumer protection: a person seeking a licensed clinician must not be misled by titles such as "psychotherapist," "counselor," or "LPCC-eligible" into believing the provider is independently licensed. The practical rule for an APCC is to disclose associate status, registration number, and supervisor identity in writing before services begin and to carry the same identification into every website, directory listing, business card, and email signature.

BPC § 4999.72 governs fictitious business names, and BPC § 651 prohibits false or misleading professional advertising — including a doctoral title that does not state the specific field of the degree.

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Fee Disclosure and Fee Changes

BPC § 4999.74 requires accurate information about the counseling relationship and the counseling process; the fee structure is part of that. A defensible fee disclosure states:

• the session fee, and any different fee for intake, extended sessions, or group work;
• cancellation and no-show charges and the notice period;
• charges for non-session services: report writing, letters, phone consultation, court appearances and travel;
• whether the counselor bills insurance, is out of network, or provides superbills;
• payment methods, timing, and the consequences of nonpayment, including any use of collections;
• the process and notice period for fee changes — the blueprint has a dedicated knowledge statement on notification of fee changes (K52).

Fee changes require advance written notice; raising a fee mid-course without notice is both a disclosure failure and, in a dispute, evidence of an unfair business practice.

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The Good Faith Estimate (K3)

The federal No Surprises Act, effective January 1, 2022 and codified for providers at 45 CFR § 149.610, applies to nearly every licensed provider, including a solo LPCC in private practice.

WHO GETS A GFE
  Uninsured clients, and insured clients who choose NOT to use their
  benefits for the service ("self-pay").

WHEN
  On scheduling, or on request.
  - Service scheduled at least  3 business days out -> GFE within 1 business day
  - Service scheduled at least 10 business days out -> GFE within 3 business days
  - On request (not yet scheduled)                  -> GFE within 3 business days

WHAT IT MUST CONTAIN
  Client name and date of birth; description of the service; expected
  service and diagnosis codes; expected charges; provider name, NPI, and
  TIN; the location of service; and required disclaimers.

THE $400 DISCLAIMER
  The GFE must inform the client of the patient-provider dispute
  resolution process available when the actual billed charge exceeds the
  good faith estimate by $400 or more.

For ongoing psychotherapy, providers typically issue an estimate covering an expected course of care — for example, a stated per-session rate multiplied by an anticipated number of sessions over 12 months — and reissue the estimate when the fee or the expected course changes materially. The estimate must be provided in writing, in a form the client can understand and accessible to the client, and a copy is retained in the record.

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Vignettes

Vignette 1 — The associate's website. An APCC's website reads "Taylor Davis, M.A., Psychotherapist and Trauma Specialist" with a phone number and fees, and no mention of registration status. Best answer: the listing violates the BBS advertising rules by omitting the registration title, registration number, and supervisor's name, and it risks implying licensure contrary to BPC § 4999.30. The claimed specialty must also be supportable under BPC § 651. The supervisor shares responsibility for the associate's public representations.

Vignette 2 — The self-pay client. A new client says she will not use her insurance and asks what therapy will cost. Best answer: she is a self-pay individual entitled to a written good faith estimate. Because the first appointment is nine business days out, the estimate is due within 3 business days of scheduling, and it must include the $400 dispute disclaimer.

Vignette 3 — The mid-course increase. A counselor raises her fee by $30 and applies it starting with the next session, mentioning it verbally at the end of the prior session. Best answer: fee changes require advance written notice with enough lead time for the client to decide how to proceed. The counselor should provide written notice, honor the prior rate until it takes effect, and update the good faith estimate for self-pay clients.