INSURANCE REIMBURSEMENT
- Many insurance carriers reimburse the cost for part or all of evaluation services, even from non-participating providers.
- Participation with insurance companies usually restricts the nature of evaluations that can be performed. Consequently, Dr. Smith does not
participate with insurance companies nor submit billing statements to insurance companies. However, most insurance companies allow you to
consult non participating providers and submit a billing statement for reimbursement.
- Procedure codes are listed in each service description (in the description of services page) to assist you when you check with your insurance
about coverage. There is also a separate list of some of the most common diagnostic codes that may be applicable in your evaluation. Contact
your insurance company to acquire accurate information concerning what is covered and the amounts covered.
- All fees for services are to be paid in full on the day services are provided. You will receive a statement with diagnostic and procedures codes
that you can submit to your insurance for reimbursement.
- You need two different pieces of information when talking to your insurance policy about coverage. The Procedure Codes and Diagnostic code
are needed when discussing this with your insurance.
- Procedure Codes: 90801 for the Intake interview
96118 for Neuropsychological Testing.
96101 for Psychological Testing
- (Sometimes the specific circumstances of the case call for a different testing procedure code 96101 for Psychological Testing instead of 96118).
- Diagnostic Codes. We cannot know which diagnostic code will be used before we meet with your for the diagnostic interview. The interview
is used to review your case and determine what the diagnoses that should be considered.
- The most common diagnostic codes are 315.00 for Reading Disorder (dyslexia) and 314.00 for ADHD. Other diagnostic codes may apply.
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