Evaluation Fees
Most diagnostic evaluations are $6,500. More involved cases are $7,500.
Which one applies depends on the case, and you will be told which when you call — before you commit to anything, and before you are asked for a card. Once quoted, that number does not change. It covers the evaluation, the report, and the follow-up work with agencies, schools, and physicians after the report is delivered.
Payment is due in full at the first visit. We do not bill insurance, though many people recover part of the cost afterward — the reimbursement section below explains how, including the codes you will need.
If that number is not workable for you, skip to the last section. It is written for you, and it is not a sales pitch.
Why it costs that
Most of what you are paying for is finding out what is not going on.
All evaluations investigate your diagnosis, even when the referral question is not well understood by you or by your doctor. An adult saying “I think I have ADHD” may have anxiety, autism, or another disorder altogether — depression, for instance — causing their trouble with attention. Our evaluations look for the cause of your symptoms, which in some cases may not be what you expect.
Ruling those alternatives out is not overhead. It is the product. An evaluation that only looks for what you already suspect is cheaper, and it is worth less — to you, to your physician, to a school, and to a court. A conclusion is only as good as the alternatives ruled out to reach it.
If the fee isn’t workable
Tell us.
We don’t sell. We don’t upsell. If an evaluation isn’t right for you, we’ll say so. If it is right for you but this isn’t the right practice for your budget, we’ll say that too — and point you toward someone who may cost less.
Some people who call don’t need an evaluation at all. We tell them that.
That isn’t a courtesy. It’s the same principle the evaluation runs on: the honest answer is worth more than the convenient one. We’d rather you get the right answer somewhere else than the wrong one here.
Insurance Reimbursement
This is a fee-for-service practice. You receive a complete superbill at the end of the evaluation, with the diagnostic and procedure codes your insurer will ask for, plus a step-by-step guide to submitting it. Many people recover part of the cost. Everything below is here to help you do that well.
The reason for working this way is worth stating plainly. Insurance authorizes testing toward a suspected diagnosis — it pays to confirm what someone already believes is going on. It does not pay for the part that matters most, which is systematically ruling out everything else. An evaluation shaped by what a plan will authorize is a different evaluation, and we are not willing to run that one and call it this one.
What that means in practice: we do not bill your plan, request pre-authorization, or pursue reimbursement on your behalf. You submit the superbill yourself, and reimbursement goes directly to you.
What reimbursement typically looks like
Outcomes range from $0 to full reimbursement, depending entirely on your plan. Nothing here is a guarantee — only your insurer can tell you what your policy will do. The ranges below are what we have actually seen.
PPO with standard out-of-network benefits: $0 to $1,000. Partial reimbursement at a percentage of the contracted rate is the common outcome.
PPO with an out-of-network exception: $0 to $1,300, where an exception can be obtained.
Plans with specialized autism or neurodevelopmental provisions: $0 to full reimbursement. Several large Silicon Valley employer plans fall into this category — Google, Apple, and Oracle among them — and we have seen these plans cover an evaluation in full. Employees at these companies are frequently told the evaluation is not covered and accept it. It is worth reading the actual plan documents rather than taking the first answer you get on the phone. The benefit is often better than people realize, and it is not always the person answering the call who knows it.
HMOs, Kaiser, and plans requiring pre-authorization: generally $0. If your plan has no qualified in-network provider, that is worth appealing after the fact — and appeals do succeed.
Accommodation evaluations: plans generally will not reimburse when the purpose is documentation for an agency or school. Where the evaluation establishes a new diagnosis, reimbursement is sometimes available — the diagnostic work is the billable part. Worth asking about specifically.
Learning disability evaluations are rarely covered by any plan.
HSA and FSA funds can be applied to the evaluation in any case.
The codes below are what you need to check your coverage. Ask about both the probable diagnostic code and the procedure codes.
Our full guide to getting insurance to pay for a neuropsychological evaluation — what to say, who to call, and what to expect.
Diagnostic Codes (ICD-10)
- F90.0 — ADHD
- F84.0 — Autism spectrum disorder
- F09 — Cognitive problems (brain injury, complicated medical concerns)
- F91.1 — Behavior problems
- F32.9 — Depression
- F41.9 — Anxiety
- F31.9 — Bipolar disorder
- F20.9 — Schizophrenia
Additional diagnostic codes can be found by searching the disorder you are asking about plus “ICD-10 code.”
Procedure Codes (CPT)
These are the codes that matter:
- 90791 — Diagnostic interview
- 96116 — Neurobehavioral status exam, first hour
- 96136 — Test administration and scoring, two or more tests, first 30 minutes
- 96137 — Test administration and scoring, each additional 30 minutes
- 96132 — Neuropsychological testing evaluation services, first hour
- 96133 — Neuropsychological testing evaluation services, each additional hour
This is not an exhaustive list. More: APA testing code descriptions.
What happens next
You call. 321-208-1554 or 321-298-8668.
Or send us your information and we will call you.
You describe the question you are trying to answer. You will be told what is involved, what it costs, how long it takes, and what an evaluation can and cannot determine. No pressure at any point. If we are not the right fit, we will say so.