Insurance Plans & Coverage

Despite its phenomenal utility, psychological testing can be quite expensive. Because of this, PACC is actively working with several major payers to ensure the provision of quality, cost-effective services.  Please check this page or email scheduling@psychassessclt.com for updates regarding the status of PACC's credentialing process.

 

Please note that all school entry assessments are conducted at the self-pay rate, as they are not considered a “medical necessity”, hence the reason that such assessments are not covered by insurance.  Please visit the “CAIS School Entry Assessments” and “Non-CAIS School Entry Assessments” sections on the “Scheduling & Fees” page for specific information regarding pricing and fees.

 

While PACC will make every reasonable effort to verify client’s insurance benefits, it is ultimately the responsibility of the client to ensure that they have appropriate coverage for the services being requested.  Below are a few questions that you may find helpful to ask your insurance provider prior to proceeding with the evaluation process.

 

Do I have mental health coverage?

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Do I have a deductible? How much is it and has it been met?

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Are there stipulations regarding the number of visits that I am allowed and/or the number of hours of testing that I can undergo?

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Does my provider have to complete a Prior Authorization Request for me to proceed with the evaluation process?

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Do I have a co-pay for psychological assessment services? If so, are CPT Codes 90791, 96136, 93137, 96130, and 96131 covered under my co-pay or will those claims be applied to my deductible?

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Are there certain diagnoses/conditions that my plan will not cover?

 

 

GOOD FAITH ESTIMATE

 

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or those who are not seeking to file a claim with their plan or coverage both orally and in writing of their right (upon request or at the time of scheduling health care services) to receive a “Good Faith Estimate” of expected charges.  Please click HERE for more information related to the No Surprise Act under (OMB Control Number: 0938-1401).