Neuropsych Evaluation Insurance Fees Explained
What is a Neuropsych Evaluation?
A neuropsych evaluation is the process of determining levels of cognitive functioning inferred from psychological testing in order to render a diagnosis, a treatment plan and a direction forward. Dr. Chambers has completed his formal re-specializing in clinical neuropsychology. He concluded his didactic training at Palo Alto University in the Summer of 2015 along w/ 2-years of formal supervision in clinical neuropsychology. Our offices are in Santa Cruz County @ 2140 41st. Ave #200B in Capitola CA, (Next to KFC) and the San Jose area by appointment only. Please call us at 321-208-1554 if you have any questions about our services. You can also reach the office manger at 321-298-8668. Our FAX number is 831-325-0125. Please explore our website to find out more information about our services. We look forward to serving you! Email is also a great form of contact firstname.lastname@example.org.
Types of Neuropsych Evaluations:
– ADD ADHD Neuropsychological Evals
– Autism/Aspergers Neuropsychological Evaluations
– Learning Disability Evaluations (Insurance Does Not Cover These)
– Neurosychological Assessment for Complicated Mental Health Concerns
– Neuripsychological Assessments for GRE/MCAT/LSAT/SAT etc. Accommodations
– 504 Plans/Accommodations/Assistance/Challenges to IEP’s (School Systems Cannot Diagnose!)
– Court Ordered Assessments/Forensic Assessments/Risk Assessments
– CA Board of Psychology EPPP/CPSE Accommodations
A neurosychological assessment can take anywhere from 1-4 sessions (or more in some cases). Psychological assessments can be broken up into shorter sessions if necessary!
**More Complex Cases will be handled through a collaborative team approach.
Insurances Accepted for Neuropsych Evaluation Services :
Tricare & Medicare ONLY.
Insurances do not reimburse for a neuropsych evaluation when it is not medically necessary (rendering a diagnosis IS medically necessary), but they DO NOT reimburse for Forensic based work, learning disabilities or exploratory purposes (e.g., is my child gifted?, what is my IQ?, am I a visual or auditory learner?)
*If you have a deductible for a neuropsych evaluation or there is some level of ambiguity in whether or not your insurance will pay for the services, you will need to pay the contracted amount up front. The contracted rate is a SUBSTANTIAL discount that the insurance companies negotiated with Dr. Chambers when he agreed to be a provider with them. These are not the same rates as cash pay, they are about 1/4 of his normal rate. If the neuropsychological testing is reimbursed and you have paid up front, any excess funds will be returned as soon as logistically feasible.
Insurance Patients Instructions:
Call your insurance carrier before your appointment. Give them both codes listed below. Use the code based on the question you want answered. If you do not know, please email and/or call us!! We will verify your coverage before agreeing to take your insurance. If there are multiple answers about coverage, or we are getting different answers than you are, you will need to leave a deposit in order to be seen.
Use the diagnosis code for the disorder you want diagnosed. Give the codes to your insurance.
Diagnostic Codes (Updated ICD-10):
- 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
Procedure Codes (Must Use Both):
- 90791- Diagnostic Interview
- 96101- Psychological Testing (For Psych Evaluation Test)
- 96118 -Neuropsychological Testing (May be under your Medical Plan)
Fees (Non-Insurance Rate):
Neuropsych Evaluation: Full evaluation $3,500-$4,500 (Sliding Scale < $50,000 per household). *This does NOT include IEP meetings, or any additional clinical work. IEP meetings are $350.00 per hour portal to portal. **Expedited report fees ($500.00).
Forensic Work: Court Testimony for Forensic & Court Based Neuropsych Testing: $400 per hour, Portal to Portal/ Wait Time (Full Evals are $4,000-$5,500).**Expedited report fees ($600.00-$1,000). 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.