How Much Does an Adult ADHD Evaluation Cost?

Why there is no single price

If you have searched for the cost of an adult ADHD evaluation, you have probably found very different answers. That is not a sign that anyone is hiding something. Evaluations simply differ in how much they include.

MedlinePlus explains that there is no single test for ADHD. A provider gathers information from several directions, which can include symptom checklists or questionnaires, interviews with people who know you, a review of your medical and family history and screening for other mental health conditions. The more of these an evaluation includes, and the more complex the question, the more professional time it takes.

This article is general information about cost. It does not give prices, because prices vary by provider and change over time.

What tends to shape the cost

When you compare quotes, it helps to know what is behind them. These are the main things that tend to drive the cost up or down:

• The question being asked: a focused question about ADHD is usually narrower than one that also asks about mood, learning or memory
• Added areas: the National Institute of Mental Health (NIMH) says some adult evaluations include tests of thinking skills such as memory, planning and reasoning, to identify possible learning disabilities
• How much history is gathered: reviewing old school records or speaking with a partner or relative takes time
• The report: a brief summary takes less time to prepare than a detailed report written for a college, testing agency or employer
• Feedback: whether a separate appointment is set aside to explain the results and answer questions
• Work done by someone else: MedlinePlus notes a physical exam may be part of ruling out other causes, and if another provider does it, CMS says a good faith estimate might not include it

Private pay or insurance

Some providers bill health insurance for evaluations, and others are private-pay only. Neither is automatically better. With insurance, what you pay depends on your plan, including any deductible, copay or coinsurance, and some plans require approval in advance. With private pay, you pay the provider directly and the price is agreed before you start.

HealthCare.gov says all Marketplace plans cover mental and behavioral health services as essential health benefits, but that your specific benefits depend on your state and the plan you choose. It also describes parity protections, which generally mean that financial limits such as deductibles and copayments for mental health services cannot be more restrictive than those for medical and surgical care.

That does not tell you whether a specific evaluation will be covered. Call the number on your insurance card and ask. NIMH also suggests checking with your insurer or your provider's billing office to confirm telehealth coverage, since policies vary from state to state.

Your right to a Good Faith Estimate

If you are paying for care yourself, a federal protection may help. CMS, the Centers for Medicare & Medicaid Services, explains how it works:

1. 1Ask or schedule aheadWhen you are not using health insurance, a provider usually must give you a good faith estimate if you ask for one or schedule at least three business days ahead. You can ask before you schedule, and the provider must then give it to you within three business days.
2. 2Check what it listsThe estimate must be an itemized list of expected charges, given on paper or by email as you prefer. It covers only that one provider, and it might not include services scheduled separately or provided by someone else.
3. 3Keep it safeCMS says you cannot dispute a bill without an estimate. If you lose yours, ask the provider for a new copy, and if you did not get one when you should have, you can submit a complaint.

Cost questions to ask before you book

Many people feel awkward talking about money with a health provider. It is an ordinary, sensible part of choosing care, and a good provider will answer plainly.

How we can help

Locascio Wellness offers an adult ADHD evaluation by secure video for people who are physically located in Pennsylvania, West Virginia or Arizona during appointments. Our evaluations are private-pay and are not billed to insurance. The cost depends on what your evaluation involves, it is given in writing before anything is scheduled, and a sliding scale is available. Our what evaluations cost page has the details.

If cost is a worry, please say so early. Send the short evaluation request form or book a free 15-minute consultation on our booking page, and we can talk through what you need. For therapy, which is a separate service, see insurance and fees and our ADHD therapy page.

If you are in crisis, call or text 988 or call 911. Locascio Wellness does not provide emergency services.