Insurance Accepted:
- BCBS/Anthem
- Kaiser Permanente (therapy only)
- Cigna
- Private Pay
Payment is due at the time services are rendered unless otherwise determined prior to the appointment.
Psychological assessments are billed by the hour when using insurance, and your out-of-pocket expense will depend upon your insurance plan’s coverage and benefits. When not using insurance, assessments are billed at a flat rate. In this latter case, you may be provided with an insurance claim form known as a “superbill” that will allow you to submit a claim to your insurance company for reimbursement based on your plan’s out-of-network benefits.
What to Know About Psychological Assessment and Insurance
When using insurance to pay for services, it is important to be well-informed about your specific health insurance plan. Some services are not considered to be medically necessary, which means the insurance will not cover the service, and the member will have to pay out-of-pocket. Psychoeducational evaluations, or testing to assess for learning disorders, will always fall within this out-of-pocket category, as they are considered to be an educational, rather than a medical need.
Insurance representatives have sometimes misinformed members that psychoeducational testing is a covered service; however, in the state of Georgia, insurance companies have 12 months to review paid claims, rescind their original decision, and seek recoupment of payment. In my 20+ years experience, I have not had a single insurance company cover psychoeducational evaluations, or if they did, they sought recoupment sometime later. Given this, I do not bill insurance for psychoeducational evaluations.
Further, just as not all services are covered by insurance, not all diagnoses are covered, either. For example, some insurance plans have exclusions for ADHD and autism and do not cover evaluations and/or treatment for these diagnoses.