• Out of pocket: parents or guardian pay directly.
  
  
• School district: the district is responsible to pay through what is referred to as an Independent Educational Evaluation (I.E.E.). In general, an I.E.E. is the legal right of a parent to have their child evaluated by an outside professional not affiliated with the school district at the district’s expense. In general, the district is required to pay if you do not agree with the evaluation provided by the district or if your child is classified as a special education student and you feel that your child is not progressing academically and / or socially. To obtain such an evaluation, districts typically require some type of formal request through the special education department. For more information regarding an Independent Educational Evaluation, click below or contact a special education attorney:
  
  Excerpt from NYS Regulation regarding I.E.E.
  
  Article about Independent Educational Evaluations
  
  
• Health Insurance Company: under this situation, the parent's health insurance company may pay for an evaluation. Unfortunately, I do not accept private health insurance for the neuropsychological evaluation of a child for a number of reasons. The main reason for this is that most insurance carriers will NOT cover neuropsychological testing when it is "in whole or in part for educational purposes." I frequently tell this to parents and most are shocked, but unfortunately, the insurance companies feel that the school district should be responsible if the evaluation has any relation to academic or school functioning. Also, in those rare instances when neuropsychological testing is covered by the carrier, I am willing to accept insurance reimbursement only when the carrier will reimburse me at currently accepted standards of reimbursement. From past experience, when I have accepted insurance in the rare instance that it was covered, the carrier did certify the appropriate number of testing hours, but the reimbursement rate approximated rates from the 1990's. In any event, the important point to remember is that virtually all commercial insurance carriers will NOT cover neuropsychological testing when it is "in whole or in part for educational purposes." For examples from some of the major commercial insurance carriers, please read below:

CIGNA: “does not cover neuropsychological testing for ANY of the following because such testing is considered educational in nature and not medically necessary. Services that are considered primarily educational or training in nature or related to improving academic or work performance are not covered under most CIGNA HealthCare benefit plans (this list may not be all- inclusive): attention-deficit/hyperactivity disorder (ADHD), developmental disability, developmental delay, learning disability, mental retardation, Tourette's syndrome, when performed primarily for educational purposes, when performed in association with vocational counseling or training.”
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BLUE CROSS / BLUE SHIELD: “Benefits are not provided for diagnostic or treatment services related to learning, curriculum planning, educational achievement or special education programs provided under the IDEA (IEP, IFSP) or 504 Plan*, as these are the responsibility of the educational system.”
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AETNA: “Neuropsychological testing (NPT) or Psychological Testing (PT) for educational reasons is not covered. This testing is usually provided by school systems under applicable state and federal rules. Most benefit plans exclude coverage of educational testing. Please check benefit plan descriptions. In addition, NPT or PT performed for educational reasons is not considered treatment of disease.”
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OXFORD / UNITED HEALTH CARE: “Testing for learning deficits, developmental disabilities, learning disabilities and/or minimal brain dysfunction is not a covered benefit for most plans. However, some states may mandate coverage for testing for learning deficits, developmental disabilities, learning disabilities and/or minimal brain dysfunction.”
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HIP / VYTRA: “Neuropsychological testing is not covered for the purposes of diagnosing any of the following conditions, as it is not considered medically necessary: ADD/ADHD, Autism, Developmental disability, Learning disability, Mental retardation, Tourette’s syndrome.”
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GHI (Managed by Value Options): "Educational testing is not a covered benefit, though this disqualifier is subject to account-specific arrangements. Assessment of possible learning disabilities, developmental disabilities or autism spectrum disorders is provided by the school system per federal mandate PL 94-142...[and]... Testing requested by the legal or school system is not generally a covered benefit." It is further noted by Value Options that an exclusionary criteria (i.e. when testing is not covered) is when, "Testing is primarily for educational purposes."
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These are just a few examples and the list is not exhaustive, but in most instances the insurance carrier writes into their policies that neuropsychological testing in whole or in part for educational purposes is not a covered service. There are rare exceptions in that some carriers may provide coverage even if the testing is for educational purposes or some may provide coverage if the learning issues are directly due to a medical diagnosis (i.e. epilepsy). However, because I do not accept insurance for testing, I ask the parent to pay me directly and then I can provide the parent with a report or bill with the proper diagnosis, so the parent can be reimbursed. Please note that in such instances, the amount the insurance company will reimburse may be less than the amount I charge for the evaluation.