How much do evaluations cost? Do you take insurance?
Each client has individualized needs and therefore, cost varies based on depth and length of services. My fees are comparable to those of other psychologists in the Bay Area. My standard hourly rate ranges from $250-$300 depending on the type of evaluation. Reduced fee services are available on a limited basis.
I am an out-of-network provider for PPO insurance plans. If you have a PPO (preferred provider organization), your insurance may reimburse you fully or partially for the evaluation as part of your "out of network" benefits.
To help make the process easier for you, I will provide you with a statement at the end of the evaluation which includes all of the necessary information to submit to an insurance company.
I recommend that you call your insurance company and ask them about their coverage for out-of-network psychological evaluations, specifically:
- What coverage is available for out-of-network psychological/neuropsychological assessment for the diagnosis in question? (e.g., ADHD, Autism Spectrum Disorder, dementia, etc.)
- Is there a limit on the number of hours for the assessment? If so, what is the limit?
- How much will you be reimbursed per assessment hour/half hour? The typical assessment "CPT" codes are: 96130, 96131, 96136, 96137.
I will be happy to fill out the forms required of out-of-network providers.
While insurance companies do not cover psychoeducational evaluations or evaluations that only evaluate for learning disorders, they often provide reimbursement if a client is also evaluated due to concerns about other diagnoses such as depression, anxiety, ADHD, etc.
What are some advantages of private pay evaluations?
I have experience working in places that take insurance for evaluations and have observed many of the following:
Waitlists can be months long. Moreover, you may wait months for the report (especially if the evaluation is conducted by a student or trainee.)
Care is often impersonalized
Due to in-network insurance reimbursement limits and the sheer volume of evaluations, reports can be "cookie-cutter" and therefore unhelpful.
Sometimes evaluators do not have access to the best, most recently updated measures because of costs - especially if they work for an organization.
You are likely to have very little control over the experience—decisions about care will be in the hands of the insurance company which is not always in your best interest.
You may have to accept an evaluator who does not have the proper depth/breadth of expertise to match your questions and concerns.
In private pay evaluations, you have complete privacy - that is, no one will know the results except for you - including insurance companies.
Evaluations done by schools do not provide a medical diagnosis and do not include recommendations for anything except educational interventions.
School psychologists are master-level clinicians who do not have training in personality/neuropsychological measures and have limited (i.e., very narrow) training in test interpretation.
Evaluations done by schools may be done in pieces by several different professionals so parents don’t get a synthesized, comprehensive understanding of how to help their child.
A private evaluator provides objective recommendations that are not biased by the school or school district.