fees/rates: We do not take a "one size fits all" approach. As such, there is no set fee for a given evaluation (except for Admissions testing) because each assessment is unique. Please visit the admissions testing page for a full list of associated fees and the common questions page for a more detailed description of the diagnostic testing process. You are invited to contact us for a free consultation for all types of assessment and consultation.
After having the opportunity to gather relevant information in the intake process, the clinician will provide you with a testing plan as well as a formally presented estimate of cost. The intake is billed at a flat rate of $350 as of 1/1/2021. This is the only part of the diagnostic testing process that can be billed and submitted to your insurance provider separately. The CPT code is 90791. If you decide to proceed, one half of the estimated cost is due to confirm and the balance will be due upon completion of the report, prior to the feedback session.
Our clinicians typically bill at a rate of $210 per hour, which increased for 2020 after many years. However, they reserve the right to bill at a different rate for consultation services depending on the nature of the engagement. For most testing processes, cost includes time for preparation, clinical decision making/planning, face-to-face testing and consultation, collateral contacts (i.e. talking with parents, teachers, significant others, doctors), scoring and analysis, report writing, etc. Feedback with the client and/or parents is included. For comprehensive evaluations, this often amounts to between 20 and 25 hours of work. Additional post-report meeting attendance and consultation is billed separately.
payment: Due to COVID-19 impact, electronic payment (ACH) via Quickbooks is requested. For diagnostic testing, full payment of the intake fee is required to confirm the appointment. Once a formal written estimate has been presented and you decide to move forward, one half of the estimated total is due to get underway; the final balance is then due upon report completion.
insurance: WPA clinicians operate as "out of network" providers. Services may be covered in full or in part by your health insurance or employee benefit plan. Insurance typically reimburses at the conclusion of psychological evaluation. Therefore, you are responsible for making payment directly to us. In turn, you will receive a statement that is appropriate to share with your insurance carrier for reimbursement. You can expect two statements--one following the intake meeting (billed separately) and one final statement at the conclusion of your feedback meeting. Please allow 7 days for processing.
It is advisable to contact your provider well in advance of testing to determine what your coverage may be. Please be aware that as of January 1, 2019, widespread changes were made to the Current Procedural Terminology (CPT ® ) code set that drives how psychological and neuropsychological testing is billed. Reimbursement remains at the sole discretion of insurance carriers and we cannot predict or take any responsibility for these decisions. Insurance panels are guided by their definition of medical necessity and will sometimes weigh diagnosis in their considerations. Benefit verification is not a guarantee of coverage, and we encourage you to ask the following questions and follow up with a supervisor when uncertainty remains:
- What benefits do you have that cover psychological evaluation (primary billing codes 96130/96131 and 96136/96137) and neuropsychological testing (primary billing codes 96132/96133 and 96136/96137)?
- What is the rate of reimbursement? (confirm that this is for an out-of-network provider)
- Is pre-authorization required? (if yes, gather information about the process and required forms, then complete as much of the form as possible before forwarding to us*)
- Are there limits to the coverage? (diagnosis, deductible, number of hours, etc.)
*Please note that pre-authorization is often a detailed, time-consuming process of petitioning beyond the initial paperwork. We are unable to offer related guidance, as we are a small practice focused on clinical matters. Time spent in this engagement beyond 15 minutes is billed in 30 minute increments at the standard rate.
Early in 2022, the No Surprises Act codified your right to receive a “Good Faith Estimate” explaining how much medical care will cost. We absolutely endorse the aspirations of this legislation, but presiding agencies have not yet clarified how assessment psychologists are expected to interpret and implement related requirements. We have always clearly stated our fees and generated a formal written estimate of cost prior to initiating services. However, while we are learning more about how we are expected to meet the below listed criteria, please feel free to ask us for as much detail and/or explanation as you would like! Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services and ask us to post the following rights:
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.
A generous cancellation policy is in place to promote a safe environment for all: We work very closely with testing participants and share materials. There are two main reasons why cancellation is required if participants are sick:
1. Studies show that even the common cold can negatively impact cognitive functioning. We want to get a sense of true functioning, under typical conditions.
2. We work in very close proximity to testing participants and share materials. Out of respect for our health and those for whom we are responsible, we follow CDC guidelines with fidelity and take extra precaution. This means that you should not come to our office if you:
* have had a fever in the last 2-3 days. CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone for 24 hours without the use of a fever-reducing medicine.)
* have been ill with vomiting or diarrhea in the last 3-4 days. Norovirus is highly contagious and remains so even after you're feeling better. Infected people are contagious when they have symptoms but also spread it a few days before and after they have symptoms.
* are actively coughing or sneezing
We regularly sanitize shared materials, utilize air purifiers, and do not come to the office if we are sick. We will not test anyone who is symptomatic--but we will prioritize a rescheduled appointment, so please be in touch!
cancellation independent of illness: We aim to treat you and your family the same way that we would hope to be treated. Sometimes missing an appointment is outside of your control. If an admissions testing appointment is cancelled within 48 hours, a $50 fee may be charged. However, we require postponement in the event of illness to preserve a healthy environment for all. Therefore, that amount is applied towards a rescheduled session.
Cancelling a diagnostic testing appointment is more complex and we appreciate as much advanced notice as possible, as there is often a waiting list for our services. A signed testing agreement and payment of the individualized deposit is required to confirm.
reduced fee: Reduced fee services are available on a limited basis. We continue to provide some pro-bono services under special circumstances.