Insurance & Fees

 

Insurance

 

In-Network

  • Blue Cross Blue Shield (BCBS)

  • AETNA

Plans with high deductibles often mean that this evaluation will go towards your deductible, which is your yearly spending limit that must be met before your insurance starts paying for services. It works like this: until you’ve paid a certain amount out-of-pocket for healthcare that year, your insurance won’t cover the full cost of services—even if the provider is in-network.

For example, if your deductible is $1,000, your plan won’t start helping with costs until you’ve paid that amount toward covered services. Once that deductible is met, insurance begins to pay their share—usually a percentage—and then you’re only responsible for co-pays or co-insurance.

We know this can be confusing (and sometimes frustrating!), so we always recommend checking with your insurance provider about where you are in meeting your deductible and what your expected out-of-pocket cost might be. We’re happy to help guide you through it as best we can.

Out-of-Network

For all other insurances, a “superbill” can be provided upon request for out-of-network services.

Without Insurance

You will be provided with a more detailed fee structure that outlines what you can expect in the assessment in a Good Faith Estimate.

Most evaluations cost from $1600 to $2000. You will receive a report with recommendations and diagnostic impressions, if appropriate. This report can be shared with pediatricians, providers, schools, and community agencies like the Division of Developmental Disabilities (DDD) to get your child the right assistance and services.

Payment, deductibles, and ALL session fees are due at the start of the clinic evaluation. All major credit cards, check, and cash are accepted.

“Superbill”

We can provide you with a “superbill” that you can submit to your insurance for reimbursement consideration. Families are often surprised to learn that their insurance will cover out-of-network providers.

If you are interested in reimbursement from your insurance company, please contact them directly. You may consider asking:

  • Do I have out-of-network benefits for

    • Psychological intake (CPT code 90791)

    • Psychological testing (CPT codes 96130, 96131, 96136 & 96137)

    • Neuropsychological testing (CPT codes 96132, 96133)

    • If so, what percentage do you cover?

  • Do I have an out-of-network deductible, and if so, how much of the deductible have I met?

  • How do I access the reimbursement form? Where do I send that form?

We offer a FREE 15-minute phone consultation to find out if we are the right place and can address your needs.