Evaluation Fees and Insurance Reimbursement

 

Payments Due: Dr. Bradley does not work directly with insurance plans. Fees are due at the time of service and are divided between two payments.

• A retainer of $1500 is due prior to the onset of the evaluation

• Remaining Balance due upon completion of the evaluation

 

Superbill: You will receive ONE “Superbill” upon completion of the evaluation, following the receipt of your final payment. The evaluation is one service that spans multiple days and insurance companies will not reimburse for incomplete services or a retainer fee.

 

Reimbursement Rates: All insurance companies and policies are different. Individuals who have questions about their policies are encouraged to check with their insurance company directly. Specific benefits for out-of-network providers vary by company and policy. The insurance company may request specific CPT codes.

 

Prior Authorization: Some insurance companies require prior authorization before they approve a neuropsychological evaluation. If your policy requires prior authorization, this needs to come from your physician. Please request this authorization from your primary care physician, psychiatrist, or neurologist. Your provider may need specific CPT codes.

 

CPT Codes: Codes for common Neuropsychological Services:

• 90791: Clinical Interview/Intake: 1-2 hours

• 96116: Neurobehavioral Status Exam: 1 hour

• 96136/96138: 1st 30 minutes of Neuropsychological Test Administration

• 96137/96139: Additional 30-minute increments of Neuropsychological Test Administration: 4-8 hours

• 96132: 1st hour additional Neuropsychological Services (Record Review, Consultation, Scoring, Interpretation, Report Writing, Feedback, etc): 1 hour

• 96133: Additional Hours Neuropsychological Services: 4-10 hours