Insurance Coverage for Neuropsychological and Psychoeducational Testing

At Tidewater Neuropsychology, we strive to make high-quality neuropsychological and psychoeducational evaluations accessible to individuals and families. Because insurance coverage for psychological testing can vary, our team works to provide clear information about fees, insurance benefits, and potential reimbursement options. Tidewater Neuropsychology is in network with several major insurance providers, including:

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• Aetna

• Medicare

• TRICARE

• Blue Cross Blue Shield

 

We also work with some additional regional or smaller insurance providers, depending on the specific plan.

Coverage for psychological and neuropsychological testing can vary based on the type of evaluation and your individual policy, so we encourage patients to contact their insurance company directly to confirm benefits.

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Out-of-Network Insurance Benefits

For services that may be considered out-of-network, many insurance plans still provide partial reimbursement.

Although Tidewater Neuropsychology does not directly bill out-of-network insurance companies, many families submit documentation to their insurance provider and receive reimbursement for a portion of their evaluation. Your insurance company can explain what percentage of the cost may be reimbursed based on your deductible, coinsurance, and out-of-network benefits.

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Questions to Ask Your Insurance Provider

If you plan to use out-of-network benefits, you may wish to ask your insurance provider the following questions:

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• What are my out-of-network benefits for psychological or neuropsychological testing?

• What is my deductible, and how much has already been met?

• After meeting my deductible, what percentage of the evaluation cost will be reimbursed?

• Is there a maximum reimbursement amount for testing services?

• Are there limits on the number of testing units or sessions that can be reimbursed?

• How do I submit a reimbursement claim using the documentation provided by my provider?

 

Insurance companies may also request specific billing codes or provider information to process a claim.

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Common Billing Codes for Psychological Testing

Insurance companies often request Current Procedural Terminology (CPT) codes, which are standardized billing codes used for psychological and neuropsychological services. Common codes associated with evaluations include:

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• 90791 – Initial diagnostic interview or intake appointment

• 96136 – Psychological testing (first 30 minutes)

• 96137 – Psychological testing (each additional 30 minutes)

• 96132 – Neuropsychological evaluation services (first 60 minutes)

• 96133 – Additional neuropsychological evaluation services or feedback session

 

If your insurance company requests additional provider information, such as an NPI number, EIN, or diagnosis codes, our office is happy to assist.

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Fees & Financial Information

Transparent Pricing for Evaluations

Comprehensive psychological and neuropsychological evaluations involve many hours of clinical interviews, testing, analysis, and report writing. Because each evaluation is customized to the individual, fees may vary slightly depending on the complexity of the case and the services required. The ranges below are intended to provide general estimates.

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Pediatric Testing Fees

Comprehensive Psychoeducational Evaluations (Children and Adolescents)

Comprehensive psychoeducational evaluations assess areas such as learning and academic performance, attention and executive functioning, memory and processing speed, and language and reasoning abilities.

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Estimated fee range:
$2,400 – $2,800

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These evaluations typically include a clinical interview, cognitive and academic testing, behavioral assessments, data analysis, scoring, a written report, and a feedback session.

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Adult Testing Fees

ADHD and Autism Evaluations for Adults

Adult evaluations may assess symptoms related to ADHD, Autism Spectrum traits, learning differences, and executive functioning challenges. These assessments may be helpful for personal insight, college or graduate school accommodations, workplace accommodations, and understanding lifelong learning challenges.

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Estimated fee range:
$1,600 – $2,400

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The exact cost depends on the type of testing required and the complexity of the evaluation.

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Insurance and Out-of-Pocket Costs

Even when insurance covers portions of testing, some services, particularly educational components of psychoeducational evaluations, may not be covered. During your initial consultation call, our team will help review your expected insurance coverage, deductibles, coinsurance, and potential out-of-pocket costs to avoid surprises.

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Out-of-Network Reimbursement

If your insurance plan covers out-of-network services, you may still be eligible for reimbursement. After testing is complete, we can provide a superbill that includes the billing codes and provider information needed to submit a claim to your insurance company. Your insurance provider can then determine reimbursement based on your plan’s out-of-network benefits.

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Why Do Neuropsychological Evaluations Cost So Much?

Comprehensive evaluations require specialized training and significant professional time, including clinical interviews, multiple hours of testing, scoring and interpretation, integration of results, and detailed report writing. These evaluations provide valuable insight into cognitive functioning, learning differences, and mental health, helping guide important educational, medical, and personal decisions.

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Questions About Fees or Insurance?

If you have questions about fees, insurance coverage, or reimbursement options, the team at Tidewater Neuropsychology is happy to help. Contact our office by emailing us at info@tidewaternp.com or calling 843-412-0927.