I am not a provider for any managed care or PPO insurance plans.
You can contact your provider and ask about their policy for covering neuropsychological assessment by an out-of-network provider. The specific procedure code (CPT) is: 96118. Please be sure to ask if they require a referral from a primary care physician. Be sure to note the name of the customer representative you spoke with, and ask for a letter stating the carrier will cover services.
In my experience, many providers deny services unless there is a medical necessity, and may refer parents to the Department of Special Education of their local School District for assessment services.
When work is completed I do provide an itemized accounting of my work which you may then submit to your carrier to determine if they will reimburse you for any, part, all of the neuropsychological assessment. The cost of assessment may qualify for an itemized medical deduction for Federal Income tax purposes or may qualify as a medical expense if you have as Flexible Spending Account through your employer.
Please note: Parents pay a retainer at the outset of my work with the family and student. My work concludes with a written report and a conference with parents and the student. At the conclusion of my work I will provide the parents with an itemized accounting, and my fees are payable in full at that point.
Please note: Your insurance carrier may set a limit on the amount they will reimburse you for these services. However, you will be responsible for the cost of my services in full. While I provide a detailed, itemized statement of account, that meets most insurance carriers requirements, sometimes carriers require further paperwork, e.g., explanations of why certain tests were used. I will provide your insurance company with this information, with your permission, but will bill you at my hourly rate to do so.
Dr P Roth, Ph.D. Psychologist 19541
1005 A St., Suite 400, San Rafael, CA 94901
Downtown San Rafael about 20 minutes north of the GG Bridge. Ample parking.
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Charles P Roth Ph.D Licensed Psychologist 19541