Insurance benefits for psychological testing/evaluations vary depending on insurance plans. Many times the coverage of testing is contingent on the patient’s diagnosis, which determines medical necessity for the testing procedures. Generally, our evaluations are conducted to determine or rule out a diagnosis, and, consequently, diagnostic information is not available until completion of the evaluation. Often times, insurance companies require a copy of the psychological report to confirm this medical necessity. Please note that insurance companies do not cover for testing that is educational in nature (i.e., to rule out a learning disorder, giftedness, etc.), as they do not consider this to be of medical necessity. More recently, insurance companies have also denied coverage of testing for Attention-Deficit/Hyperactivity Disorder (ADHD).
Our office payment policy for testing is that payment needs to be made at the time of testing. If you have insurance and are interested in seeking reimbursement for some of your testing expense, we will be happy to provide a detailed invoice once the testing is completed and payment has been submitted. We do not submit insurance claims directly to insurance companies for testing. This is the insured’s responsibility. It is advisable for you to contact your insurance company directly to obtain a detailed explanation of your benefits and procedures for submitting claims related to evaluations, including any authorizations required prior to testing. If needed, we will complete any clinical forms required by the insurance company (such as treatment plans or prior authorization forms); however, it is the insured’s responsibility to inform us of what is required by your insurance policy.