You may be wondering whether you or your child have ADHD or a learning disability such as dyslexia (reading disorder). There are several options for getting evaluated, and these will determine the cost and method of payment. Read on for some information about the ADHD evaluation cost (as well as the learning disability evaluation cost).
Here are the the three options you have to get an ADHD evaluation.
Primary Doctor or Pediatrician (insurance copay)
You can go to your primary care doctor or pediatrician for assessment of ADHD. This may be covered by insurance or Medicaid, which would leave you with paying your co-pay or deductible in some cases. However, generally insurance cannot be billed for learning disability assessment since this is not considered “medically necessary” by many insurance companies. Pediatricians are quite familiar with medication options for ADHD. This is probably the least expensive ADHD evaluation cost option.
Psychiatrist (insurance copay)
You can go to a psychiatrist for ADHD assessment, which may be covered by insurance or Medicaid. However, psychiatrists cannot assess for learning disabilities or provide the necessary testing or documentation to be considered for educational accommodations for learning disability. The great part about going to a psychiatrist is they (typically) do an exceptional job of identifying the correct medication to manage the ADHD symptoms plus other co-existing mental health symptoms, if present (such as depression or anxiety). One side effect of ADHD medication can be sleep problems or anxiety, and so it can be tricky to find the correct medication regimen to manage these symptoms. Psychiatrists can have long wait times to get in for an appointment.
Neuropsychologist or Psychologist ($500-2000)
You can go to a neuropsychologist or psychologist. This service may be covered by insurance or Medicaid, or paying cash may make sense. The psychologist may also be able to provide testing, which may give an objective indicator of attention problems (e.g., your child is scoring at or above 50% of other children his/her age in this area of attention, grade level/age level or equivalency). Testing is nice to have because it is repeatable and can show you gains made with intervention. However, the most essential ingredient of the ADHD assessment is the diagnostic interview. For the learning disability assessment, testing is ESSENTIAL and helps determine the diagnosis. Neuropsychologists are frequently interested in working with the school to ensure the test information is well understood by the educator. However, it may be difficult to get all testing covered by insurance in some cases, particularly in cases of learning disability. The ADHD evaluation cost (as well as the learning disability evaluation cost) can go up with testing.
Summary of ADHD Testing Costs and Why Choose a Neuropsychologist for ADHD Testing?
The current standard of care is that all providers should do a clinical interview with the patient and significant other (such as parent), administer standardized rating scales from multiple people, and review your medical, social, and family history.
In the evaluation of ADHD, neuropsychological testing is indicated IF there is evidence of low cognitive ability or low academic achievement, or to evaluate for co-existing conditions. So, if you think there might be other things going on besides ADHD, such as learning disability, autism spectrum, or additional mental health conditions, this is where I tend to refer for testing. This can also be the case when there is a strong family (genetic) history of neurologic conditions that could also cause attention problems. I suggest a neuropsychologist as the appropriate referral source, given the neuropsychologist’s specialized training in brain-behavior relationships. The testing may be helpful in pointing toward a need for educational accommodations, services in the school setting that can help remove limitations in learning.
Testing is particularly critical when you are looking for educational accommodations (to see whether the child or adult has a condition that amounts to a disability). You can see whether a school psychologist might perform the testing, but sometimes the school psychologist will want to refer you to a private psychologist because s/he does not feel comfortable making a diagnosis and will only be qualified to do some educational testing. Comfort levels on the part of the school psychologist may vary.
Many neuropsychologists in private practice charge upwards of $500-$1000 to conduct psychological or psychoeducational testing needed to document academic problems related to ADHD. Frequently you cannot find a neuropsychologist in a hospital setting who will conduct learning disability testing, since this is not often considered medically necessary and that is how the neuropsychologist in the hospital setting gets paid (through insurance reimbursement). If the evaluation is for learning disability (such as dyslexia or reading disorder), it is most likely that insurance does not cover this, since it is not for medical purposes but rather for educational purposes. I currently charge $500 or $600 for learning disability testing, depending on the extent of the testing that is required, and am able to be flexible with pricing in some cases due to economic hardship. However, it is not uncommon for neuropsychologists to charge $1000-$2000 for a learning disability evaluation with testing.
It can be challenging to cope with cognitive difficulties such as attention or memory or learning / reading problems, especially when there are unanswered questions about the exact nature of these problems, its cause, or its course. Even more challenging can be taking that first step toward obtaining a diagnosis, and identifying the right professional to conduct the evaluation. Hopefully this blog has assisted you in identifying your options and the correct professional to help you!