Does Insurance Cover ADHD Testing?

Insurance coverage for ADHD testing can be confusing. Here is how it usually works and what to ask before your evaluation.

Is ADHD testing usually covered?

Often, yes. ADHD evaluations are usually covered as a mental health benefit. Federal parity laws require many health plans to cover mental health care on similar terms to physical health care.

But "covered" does not always mean free. You may still owe a copay, coinsurance, or the full cost until you meet your deductible.

What is often covered vs. not

Often covered:

• Psychiatric evaluation with a licensed clinician
• Follow-up visits and medication management

Sometimes not covered:

• Some computerized or neuropsychological testing
• ADHD coaching
• Out-of-network providers

Call the number on the back of your card and ask:

1. 1Do I have mental health or behavioral health benefits?
2. 2Is telehealth covered?
3. 3Is the provider in network?
4. 4What is my copay or coinsurance for a psychiatric evaluation?
5. 5Have I met my deductible this year?
6. 6Do I need a referral or prior authorization?

Insurance at Anora

• Georgia and North Carolina: We accept Aetna and Cigna. Insurance is applied after your initial purchase.
• All other states we serve: Our services are self-pay at this time.

Our self-pay prices are simple. Evaluations start at $195. Many people use an HSA or FSA card.

Is self-pay ever the better choice?

Sometimes. If you have a high deductible, a self-pay evaluation can cost less than what you would pay through insurance. It can also be faster, since there is no waiting for approvals.

The bottom line

Insurance often helps with ADHD testing, but plans vary. Call your plan with the questions above, or start with a clear self-pay option that begins at $195.