INSURANCE COVERAGE FOR PSYCHOEDUCATIONAL TESTING
We do not accept insurance for testing. Most claims are denied by insurers.
Most insurance plans do not cover psychoeducational testing since
the testing is related to school/education issues and not primarily a psychiatric/medical condition. Even for ADHD, insurance usually allows only a consult with a physician or psychologist/mental health practitioner.
suggest that you call your insurance carrier if you would like to determine if
psychoeducational testing is a covered service on your plan. Coverage, if it exists, can vary from plan to plan. You would want to seek out a provider who is on your plan's provider list if there is coverage .
Be sure to tell them you are checking for PSYCHOEDUCATIONAL TESTING for possible learning and/or attention disorder. If you say psychological testing it implies psychiatric/psychological problems as opposed to learning issues.
insurance company may ask for CPT codes, which describe the types of
procedures to be performed. For a psycho-educational
evaluation, these are the codes you will need (these are not all inclusive, different tests/situations may be handled in another manner):
POSSIBLE PROCEDURE CPT BILLING CODES:
The procedure code for testing that is often used:
You should specify that the testing will be psychoeducational!!!!!
Question: Is more than 1 hour per day of psycho-educational testing allowed?
Question: In addition to licensed psychologists, are Florida licensed School Psychologists (licensed by FL Dept. of Health) covered providers?
Question: Do I have to use a provider affiliated with your plan or can I see any Florida licensed psychologist or school psychologist.
SAMPLE DIAGNOSTIC CODES:
314.01 ADHD Combined Type
SPECIFIC LEARNING DISORDER CODES:
315.2 Written Expression
We are not providers for Tri-Care, check with a Tri- Care provider about coverage if that is your insurance.