Insurance Coverage & Fees

Will my insurance cover the evaluation? 

The availability of insurance coverage depends on the type of evaluation and your specific benefits.  In general, insurance will not cover evaluations that are related to educational needs or determinations, or for the diagnosis of ADHD.  

If you child requires a full diagnostic evaluation (meaning that the evaluator will be assessing for the presence of mental health conditions like depression as well as educational concerns), your insurance may cover the testing after you've satisfied your deductible and pay any copayments/coinsurance.  

While there are, in most cases, financial benefits to having your insurance pay for the evaluation, here are some things to keep in mind: 

• Insurance companies will always require the evaluator to provide a covered "diagnosis" for billing purposes. Oftentimes, it has no bearing on your child but you should be aware that it becomes a part of their medical record.

• Approval is typically required after the initial assessment and before testing can be scheduled. The time frame for receiving this varies greatly from one carrier to another.

• The evaluator will not finalize and/or provide the report until payment is received from your insurance, meaning that you could be waiting weeks to receive the report due to an administrative delay.