Insurance Plans
I no longer accept any type of insurance. The cost of my evaluations will be paid by each client at the beginning of each visit. I can provide you with an invoice that you can send to your insurance company and they may reimburse you for part of what you pay me. I will not bill insurance on your behalf. You are responsible for making payments for the evaluation. At the end of the evaluation a report will be provided to you after your balance has been paid in full.
Prior to making an appointment you should check with your insurance company as many plans require preauthorization prior to doing any psychological testing. If your plan requires preauthorization for psychological testing, I will be glad to complete these forms for you. I will just need a copy of the forms to complete. If psychological testing is not preauthorized, and your plan requires psychological testing preauthorization, you may not get any reimbursement from your insurance company.
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.
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.