The cost of an autism evaluation varies by region and by provider. In Virginia, prices can range from $1,200 to $3,000. For clients unable to use insurance, or who don’t want to wait months or years on waitlists with in-network providers, finding an affordable evaluation can be challenging.
What Does an Autism Diagnostic Evaluation Entail?
Many providers use some form of standardized testing during the evaluation process. Some providers rely solely on these standardized tests, and other providers combine them with a clinical interview. If you are receiving neurophysiological testing for all potential conditions, not only for autism, it’s likely you will complete a multitude of standardized assessments. If you are being evaluated just for autism, there may be only a few forms to complete.
Screenings Vs. Evaluations
The type of provider who can diagnosis autism varies by state. In Virginia, autism can be diagnosed by a physician, psychiatrist, psychologist, nurse practitioner, or licensed therapist. Some companies may offer screenings, which are not diagnostic. Screenings can give you an indication of if you’re autistic or not, but no final diagnostic finding is reached. Be careful when you’re scheduling an assessment to determine if what you’re paying for is a screening – which cannot be used to receive accommodations at school or work – or an actual diagnostic evaluation.
Self-Pay Autism Testing in Virginia at Onward Growth Psychiatry
We know that out-of-pocket care can be intimidating and expensive. That’s why we work to keep our rates as low as possible. At Onward, we provide diagnostic evaluations – not screenings – that include a comprehensive evaluation appointment, some standardized testing, and a written evaluation. We work diligently to keep our prices as low as possible, because we understand the pain point of paying out of pocket. We have found that our rates routinely are lower than other providers in Virginia.
Out of Network vs Out of Pocket
Out of network doesn’t necessarily mean you are left with the entire cost of services. If you have out of network benefits with your insurance company, you can submit a receipt, called a superbill, to your insurance. Your insurance will then reimburse you a percentage of the overall cost.
When you see an out of network provider, you pay for the entire cost of services upfront. Then, you file a claim with your insurance company (using the superbill), and your insurance reimburses you part of the cost. Insurance companies do not usually reimburse you based on the amount you actually paid your provider. Instead, they reimburse you based on what’s called the allowable amount for the service you received. This means if your insurance has determined they will pay $500 for an autism evaluation, and you submit a superbill for $750, your insurance will reimburse you $500.
For most people, their insurance will not reimburse for the cost of care unless the deductible has been met. Some people choose to submit the superbill to their insurance knowing they will not be reimbursed, because the amount they paid will be applied to their deductible.
You could also consider using a service that deals with claims for you, like Reimbursify or Thrizer. These services charge a small fee in exchange for helping you get reimbursement from your insurance company, so they may help you get more money back in the long run.
Self-Pay Autism Testing in Virginia
Out of Network Vs Self-Pay
Some providers are truly self-pay, meaning they will not provide superbills. Some providers choose to practice in this way because they have had such terrible experiences with insurance companies in the past. If you are looking for self-pay autism testing Virginia, be sure to specify with the provider if you want to be self-pay, or if you would like to be out-of-network, meaning you need a superbill. At Onward, we provide all our clients with superbills upon request.
So, How Much Does an Autism Evaluation Cost Out of Pocket?
Onward Growth was founded by a single mother, who understands the pain point of paying for out of network care. To keep care accessible, autism evaluations for children (ages 6-17) are priced at $500 and evaluations for adults (ages 18-55) are $750. If you’re interested in neuro-affirming self-pay autism testing in Virginia, learn more about our providers and the services we offer. Click here to learn more about Tabitha, and click here to learn more about Autism evaluations by Onward.
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