|Paying for Testing
What is the fee for testing?
Fees vary, depending on the extent of the testing requested. The fee for a standard battery of psychological, neuropsychological, or psycho educational tests is $1950.00. More extensive testing or other services will be charged separately. Very limited testings, addressing a very specific question, may be available for a lower cost. (See below for information about insurance coverage or about getting your child's school to pay the bill).
What does the fee cover?
The fee covers any initial interview and/or other initial information gathering (in person or by phone); administration of tests and scoring and analysis of test results; preparation of a written report; and any feedback session (by telephone or in person) with you or your representative. It also covers other routine communications with you, school, physician, etc. Less usual services, such as unanticipated additional testing, preparation of records, attendance at school “PPT” meetings or other follow-up meetings, or my participation in legal proceedings that you become involved in are additional and are billed separately.
When do I pay for the testing?
Unless other arrangements have been made prior to the testing, please pay at least one half of the total fee on or before the initial testing session with your child. The remainder must be paid before the written report will be submitted to you. Failure to comply with these procedures may result in a delay in the testing. Please make out checks to: John H. Ehrenreich, Ph.D.
Can I get my local school district to provide the testing my child needs?
In theory, the school district in which the child attends school is obligated to provide psycho educational testing (but not neuropsychological testing or psychological testing) for children who need it. Sometimes they provide the testing directly. Other times they will pay the fee for an outside psychologist to do the testing.
Parents have reported several potential problems with having the school do the testing. First, the school district has to agree that the child needs testing, and they are sometimes reluctant. Second, there may be a relatively long delay before they actually get to your child. Third, schools may limit their testing to measuring overall ability (“IQ”) and assessing academic skills such as reading, writing, and math. Other areas of possible concern, such as ADHD, language, memory function, and social and emotional issues may not be covered.
If you would prefer to have the testing done independently, talk to your school psychologist or school Special Ed director. Sometimes the school is willing to pay for an outside testing.
If the school does test your child and you believe further testing (or a second opinion) is warranted, you have the right to have an outside testing done. The school may or may not cover the costs. Feel free to discuss this with us.
Will my health insurance cover testing?
Most health insurance policies do cover testing if they consider testing to be "medically indicated." "Medically necessary" means either that the problems you or your child have that require testing are the results of a medical issue (e.g., a head injury, Lyme Disease, a seizure disorder) or there is a psychiatric diagnostic issue that cannot be resolved just by interviewing the person. Most insurance companies do not cover testing for educational purposes (as opposed to medical or psychiatric purposes), but occasionally, a policy does provide coverage. If there is a medical or psychiatric issue which the testing will address, the insurance company may provide full or partial coverage.
These are the steps you should follow to find out whether your insurance company will help pay for the testing:
1. Call your insurance company and ask whether your child is covered for codes 96101 (“psychological testing”) or 96118 (“neuropsychological testing”). When you call, be sure to specify the reason for the testing (e.g., ADHD, learning disability) and be sure to ask explicitly whether testing is covered for that reason.
2. If you are told that testing is covered, ask if you will need “precertification” or “preauthorization” (i.e., advance approval). Also ask if I am "in network" and, if not, if there is "out of network" coverage.
3. If your insurance company tells you that testing is covered, let me know immediately. It is essential that I contact the company directly to confirm your coverage well in advance of the scheduled test date. The insurance companies sometimes tell the subscriber one thing and the provider something very different. In any case, arranging precertification can take a week or two, and failure to follow the company's procedures may result in the claim being denied.
For more on insurance coverage issues, click here.
What if insurance won't cover the costs and I can't afford the fee?
There are various alternatives. Your insurance company may pay in whole or in part (see below). Your child's school or your employer may be willing to pay, in whole or part. A payment schedule, stretching out payments, can be arranged. In some cases, a sliding scale is available. Discuss the issue with me at the start of the process.