Accepted Insurance Plans
Please note that we only accept BlueCross/Blue Shield (BCBS) insurance. We do not accept any type of TennCare or BlueCare even though it may fall under BCBS. Assessment fees for those using insurance will vary depending on your coverage and benefits. These are different for each particular plan. Some plans have a particular co-pay that is due at the beginning of each session. With other plans you may have a high deductible that must be met before insurance will begin to pay. For this reason, I cannot give you an accurate estimate of your out-of-pocket expenses prior to our first visit because each plan is different. I would recommend that you call your insurance company to determine your out-of-pocket expenses.
While I do conduct evaluations for learning disorders in reading, math, and writing (including Dyslexia, Dyscalculia, and Dysgraphia) insurance typically does not cover the cost of these evaluations because insurance companies do not consider these evaluations “medically necessary”; however, you should check with your insurance company to be sure as each plan is different and there are a very few plans that will cover this cost. When calling your insurance carrier to determine if my services are covered it may help to have a few codes when you call. Typically, the person you talk with at the insurance company will need a diagnosis code and a procedure code to determine if the service is covered. The diagnosis code will depend on the presenting concerns that you have. Codes for each condition are different and there is no room to list them all here; however, common ICD-10 diagnosis codes for learning disorders are: F81.0 Specific Reading Disorder, F81.2 Mathematics Disorder, and F81.81 for a Disorder of Written Expression. The procedure codes (often called CPT codes) that I use for psychological testing are 96136, 96137, 96130, and 96131.
If you have an insurance plan other than BCBS we can still see you or your child. You will have to pay out of pocket for my services. I can give you the information you need to send to your insurance company for reimbursement. Please note: I will not bill insurance on your behalf.
I’ll be happy to discuss my fees with you over the phone. The assessment process is more than the time we spend face to face in our sessions. The time I bill includes face-to-face time in the sessions, scoring the assessments, analyzing the results, writing the report, reviewing the results of the evaluation with you, and other administration time related to your assessment (i.e., review of records, sending information and forms to teachers and others, contacting other professionals, and other work related to your assessment). The time and cost will be different for each evaluation as the testing and number of sessions depend on the complexity and number of assessments needed. Payment will be required at the beginning of each session. A report will be provided only after your account has been paid in full.