Finances & Fees
All evaluations investigate your diagnosis even if the referral question is not well understood by you or by your doctor. For example, an adult stating, “I think I have ADHD” may have anxiety, autism, or another disorder altogether such as depression etc. causing their issues with attention. Our evaluations look for the cause of your symptoms, which, in some cases, may not be what you expect.
When an evaluation or a referral question has a medical component or a potential medical component it is always classified as a neuropsychological evaluation which is more in depth, more time consuming, and thus more expensive. Examples include seizures, traumatic brain injuries (TBI), multiple sclerosis, memory problems etc.
Anytime your case has a legal component such as the CA Bar Exam Accommodations, MCAT Accommodations, GRE Accommodations, SAT Accommodations, LSAT Accommodations etc., family law, criminal law, probate law, or if it is “court ordered” etc. it is considered a forensic case, and it is much more time consuming, litigious, and thus more expensive. IEE’s also fall under this category in some cases.
Here is our general pricing model:
- Psychological Evaluations = No confirmed or potential medical and/or confirmed or potential neurological issues. ADHD/adult autism w/o medical complications fall under this category. Costs: $3,000.00-$3,500.00. UCSC Students are $2,500.00 for ADHD evals.
- Neuropsychological Evaluations = Any evaluation where there are complicated medical and/or psychological, and/or cognitive issues. Examples include: learning disorders/disabilities (LD) [e.g., dyslexia, dyscalculia, agraphia], traumatic brain injury (TBI) and post concussion syndrome, autism spectrum disorders for children, “school problems,” medical issues, cysts, seizures, strokes, memory problems, executive dysfunction, prodromal schizophrenia etc. Costs: $3,500.00-$5,000.00. UCSC Students are $3,000.00 for LD evals.
- Forensic Evaluations = [Can be psychological or neuropsychological] Anytime a case involves family law, criminal law, court ordered evaluations, accommodations, and any form of disability, workplace exemptions etc. it is priced as forensic. Costs: $4,000.00-$5,000.00.
Additional Forensic Work (Click me): Court Testimony for Forensic & Court Based Neuropsych Testing: $400 per hour, Portal to Portal/ Wait Time. Deposition charges are ($400 hourly, no minimum). Court testimony is $400.00 per hour with a 4-hour or half-day minimum. Out of area related travel is billed $400.00 hourly. Record review in excess of 100 pages is $400.00 per clinical hour.
**Expedited report fees ($600.00-$1,100).
Insurance Reimbursement: Your insurance, if it is a PPO plan, may give you some reimbursement for a neuropsych evaluation. Typically, with standard out of network benefits, you will receive 65% of the contracted rate which is around $500.00-$600.00 total. Sometimes you can obtain an out of network exemption, and receive approximately $900.00-$1,000.00. We will bill the insurance company for you if requested through our clearing house. However, our fees are due up front on the first visit. The check from the insurance company will be sent to you. If it is sent to us, we will cut you a check for that amount. HMO’s, Kaiser, or insurances that require “pre-authorization” will not reimburse you.
Below are the codes you can use to inquire about your insurance coverage and out of network coverage. Please use both the probable diagnostic code, and the procedure codes as well.
Diagnostic Codes (Updated ICD-10):
- Learning Disabilities are NEVER covered by insurance, neither are court-related, court-ordered, or accommodation evaluations
- 314.00 (F90.0) ADHD
- 299.00 (F84.0) Autism
- 294.9 (F09) Cognitive Problems (e.g., Brain Injury, Complicated Medical Concerns)
- 312.81 (F91.1) Behavior Problems
- 311 (F32.9) Depression
- 300.00 (F41.9) Anxiety
- 296.80 (F31.9) Bipolar Disorder
- 295.90 (F20.9) Schizophrenia
*Additional diagnostic codes can be found by searching the disorder you are inquiring about + “ICD-10 code” on Google.
Neuropsych Evaluation Current Procedural Terminology Codes: (CPT)
***CPT Codes have changed as of 2019. Dr. Chambers and his staff will work on updating their knowledge about the changes. As of January 1, 2019 we can no longer submit billing though our clearing house until we update ourselves with the new changes. Please periodically check back for updates on our progress.