You've finally decided to get answers. You've suspected for years that your brain works differently — maybe you've watched endless TikToks about ADHD, or you've read every article on autistic burnout while sitting in your car in the parking lot at work, wondering why nobody else seems this tired. You pick up the phone to call a psychologist, feeling a mix of hope and terror.

And then they tell you the price.

"That will be $3,500. We don't take insurance. Next available appointment is in November."

It feels like a door slamming in your face. It feels validating (this is specialized work) and invalidating (only the rich deserve to know who they are) at the exact same time. And in that moment, a lot of people just... close the door. Go back to coping. Go back to masking. Go back to wondering.

I don't want you to close the door. So let's talk about why testing costs what it does, why insurance companies play games with your coverage, and — most importantly — how you can actually afford to get the answers you deserve.

Part 1: Where Does the $3,500 Actually Go?

When you pay for a medical test — like an MRI or bloodwork — you're mostly paying for the technology. A machine goes beep, and a computer spits out a number. With psychological testing →, you're paying for something radically different: human expertise measured in hours.

A comprehensive autism/ADHD evaluation is not a multiple-choice quiz. It's a forensic investigation into your brain's operating system. Here is what actually happens behind that price tag:

  • Clinical Interview (2-3 hours): This isn't chatting. I'm tracking nuance, sensory responses, eye contact patterns, communication style, and your deep history. I'm listening for the thing you say in passing that you don't think is important but absolutely is.
  • Testing Sessions (4-6 hours): Face-to-face administration of standardized assessments — WAIS-IV cognitive testing, executive function batteries, ADOS-2, and other tools depending on what we're looking for.
  • Scoring & Interpretation (3-5 hours): Scoring the raw data is the easy part. The hard part is integrating it. How does your high processing speed mask your working memory deficit? How does your anxiety inflate your attention scores? This is where the detective work happens — and it's the part you're actually paying for.
  • Report Writing (4-6 hours): A good report is 20+ pages. It takes hours to write a document that captures not just what you have, but who you are. We call ours a Brain Guide because "report" sounds like something that happens to you, and this is something we build with you.
  • Feedback Session (1-2 hours): Walking you through the results, explaining the diagnosis, and developing an actionable plan →.

Total: 15–25 hours of doctoral-level clinical work.

When you break it down, $3,500 averages to about $140–$230 per hour — which is actually less than what most therapists charge for a 50-minute session. The sticker shock comes because you're paying for a massive block of time all at once, not dripping it out in weekly copays.

For context, the national average for a comprehensive neuropsychological evaluation in 2025 ranges from $2,000 to $5,000, with premier specialty centers charging $9,000-$14,000. We are very intentionally on the accessible end of that spectrum.

Part 2: The "Medical Necessity" Trap

"But I have insurance! Why won't they pay for it?"

Oh, this one makes my blood boil. Let me explain the logic insurance companies use, and then I'll explain why it's wrong.

Insurance companies operate on a definition of "Medical Necessity" that goes something like this: Is this procedure required to treat an acute illness or prevent death?

  • Depression/Anxiety: Medically necessary. Covered. (Usually.)
  • Autism/ADHD Assessment: Often classified as "educational" or "developmental" — not "medical."

Insurance companies will deny testing claims by arguing:

"Knowing you have autism won't change your medical treatment, therefore the testing is educational, not medical."

Let me translate: they're saying that understanding your own brain isn't medically necessary. That knowing why you've been struggling for decades doesn't count as healthcare. That the difference between "you're lazy" and "your brain literally processes information differently" isn't worth their investment.

Meanwhile, research consistently shows that the single greatest barrier to diagnosis is the prohibitive financial cost, with assessments running into thousands of dollars and rarely covered by insurance for adults. It's not that people don't want to know — it's that the system has priced self-knowledge out of reach.

The Pre-Authorization Shell Game

Many plans require "Pre-Authorization" for testing. Here's how the game works: I have to submit codes telling insurance what I suspect you have before I test you. If I'm wrong, or if the testing shows you don't have what I pre-authorized for, they can retroactively deny the claim — leaving you with the entire bill months later.

(Yes, really. You can get denied coverage because you turned out to be healthy. The system is genius.)

Because of this financial risk — and because insurance reimbursement rates for testing are often 50% below market rate — most specialized assessment clinics have stopped taking insurance entirely. It's not greed. It's that providing neurodiversity-affirming, high-quality assessments → is literally unsustainable on insurance reimbursement.

Part 3: How to Actually Pay for It

Okay, the system is broken. We know that. But you still need answers. Here's the strategic roadmap.

1. The Superbill Strategy (Your Best Bet)

If you have a PPO insurance plan, you likely have Out-of-Network benefits. This means you pay the clinician upfront, and we provide a "Superbill" — a detailed receipt with the right medical codes. You submit it to insurance, and they reimburse you a percentage (usually 50-80% after your deductible).

The hack: Call your insurance before you book. Ask exactly this:

  • "I want to check my Out-of-Network coverage for CPT Code 96130 (Psychological Testing Evaluation) and 96136 (Psychological Test Administration)."
  • "What is the 'Allowed Amount' for these codes?"
  • "Do I need pre-authorization for out-of-network psychological testing?"

Write down the reference number for the call. Insurance companies have been known to give different answers on different days, and having a reference number is your paper trail.

2. Use Your HSA/FSA

Psychological testing is always a qualified medical expense for Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA). This essentially gives you a 20-30% discount because you're using pre-tax dollars. If you've been hoarding your HSA balance waiting for the right medical expense — this is the right medical expense.

3. CareCredit & Medical Financing

Many practices accept CareCredit, which is basically a credit card for medical expenses. They often offer 0% interest for 6-12 months. If you can pay it off in that window, it's essentially a free loan. (Just don't miss a payment — the deferred interest is brutal.)

4. University Training Clinics (The Budget Option)

If private practice prices are out of reach, look for University Psychology Clinics. These are training clinics where doctoral students conduct assessments under licensed supervision.

  • Pros: Very thorough (students are graded on accuracy) and much cheaper — often sliding scale based on income.
  • Cons: Wait times can be long, and the process takes longer (months instead of weeks).

5. Ask About Payment Plans

This is the thing people forget to ask: many private practices — including ours — offer payment plans. You don't always have to drop $3,500 in one shot. If nobody mentions it, ask. The worst they can say is no.

Part 4: Is It Worth It?

Only you can answer that. But let me reframe the question: What is the cost of NOT knowing?

  • What's the cost of treating "anxiety" for 10 years when the root cause was sensory overwhelm?
  • What's the cost of believing you're "lazy" or "broken" when you actually have executive dysfunction?
  • What's the cost of burning out every 18 months because you're forcing a neurodivergent brain into a neurotypical mold?
  • What's the cost of your kid spending another year thinking something is wrong with them when the truth is their brain just runs a different operating system?

I've sat across from adults who cried when they finally got their diagnosis — not because they were sad, but because they were relieved. Decades of "what's wrong with me?" answered in a single sentence: nothing is wrong with you. You've been using the wrong manual.

Testing is expensive. But ignorance is costlier.

If you're ready to get answers, let's talk about your options →