Payment/Authorizations
Cost & Payment
I am an out-of-network provider for most insurance companies. This mean that I cannot bill insurance companies directly. Many plans will reimburse you for services with an out-of-network provider. You are encouraged to determine the specific reimbursement schedule for your plan (see below). Itemized invoices detailing the services provided are provided. Payment is required on the day of service (or first day of testing). The cost of each testing may vary. You are encouraged to call and discuss the specifics of your case to better understand the potential cost. Below are descriptions of the most common kinds of testing completed.
Comprehensive Neuropsychological Evaluation: Includes Intake, Evaluation (Cognitive, Academic and General Psychological), Report, Collateral Contact. Separate feedback with parents and child.Typically consists of up to 2 days of testing.
I do attend IEP Meetings. This is typically an additional cost beyond the testing itself.
All reports are written to meet the demands of the IEP process and standardized testing companies requirements for accommodations.
Adjusted testing fees for specific testing requests (ex: WISC-V Administration or Reading Progress Assessment) as well as hourly fees for consultation, school observation, record review and phone contact are also available.
Please note, the fee for testing can be discussed at the time of the initial phone call. The fee will be increased January 1st, each year, to reflect cost of living.
Reports & Testing
Working with Insurance Companies
PPO plans often cover for out-of-network providers. If you have such a plan, it is possible that you will have at least some of the testing fee reimbursed. Unfortunately, HMO plans do not reimburse out of network providers. It will be important for you to explore your plan's coverage for neuropsychological testing, co-pay, deductible and your testing needs (particularly if you will be paying for Academic testing anyway) when you decide whether to use an in-network or out-of-network provider.
If you are using a PPO, check with your insurance company about whether an authorization is needed. I will be able to complete the paperwork needed if required.
When Calling Your Insurance Company to determine PPO coverage for an Out-of-Network Provider.
The following information may be helpful in the process of determining your insurance company’s ability to reimburse for services as an out-of-network provider. My National Provider Number (NPI) is 1063578235. The following CPT (Current Procedural Terminology) codes are used for the various services provided. Commonly used codes include: As of 1/1/19 CPT Codes for Neuropsychological Testing include the following (with very approximate hours associated): 96116/96121 (2 hrs); 96136/7 (10 hrs); and, 96132/3 (10 hrs).
United Health Care Customers: Your Behavioral Health Services are typically covered through Optum. I will likely have to complete a form to gain addition hours (beyond those not requiring authorization). Click here to see the page from which I download the Psychological and Neuropsychological Assessment Supplemental Form. Please call your company to confirm that your specific plan uses this form and the kind of coverage you will receive for the CPT codes mentioned above.
For more detail on which CPT codes I use please click here to access the form.
