Back to ADHD Hub
Insurance Coverage Guide

ADHD InsuranceCoverage & Benefits

We accept Medicare, Medicaid, and most major insurance plans for ADHD testing and treatment

8 insurance providers accepted • Free benefit verification • No surprise bills

Insurance Plans We Accept

Comprehensive coverage with major national insurance providers

Medicare

Comprehensive ADHD coverage

No prior auth required

Medicaid

Full evaluation and treatment coverage

Coverage varies by state

Aetna

ADHD testing and medication management

Prior auth may be required

Blue Cross Blue Shield

Covers ADHD evaluation and follow-ups

Most comprehensive coverage

Cigna

ADHD services covered under mental health benefits

Check your specific plan

UnitedHealthcare

ADHD diagnosis and treatment covered

Verify deductible status

Humana

ADHD evaluation and medication management

Copay structure varies

Anthem

ADHD services covered with referral

Referral may be required

Other Insurance Plans

If your insurance provider is not listed above, we may still accept it. Call us at 678-437-1659 to verify coverage or request a superbill for out-of-network reimbursement.

What Insurance Covers

ADHD evaluation, testing, and medication management services covered by most plans

Initial ADHD Evaluation

CPT Code: 99214 or 99215

Comprehensive clinical interview, symptom assessment, medical history review

Yes - Most Plans

TOVA Computerized Testing

CPT Code: 96116

Objective attention and executive function testing

Yes - Most Plans

Psychoeducational Report

CPT Code: 99080

Detailed evaluation report and recommendations

Usually Covered

Follow-up Medication Management

CPT Code: 99213 or 99214

Monthly or periodic medication adjustments and monitoring

Yes - Most Plans

ADHD Medications (Generic)

CPT Code: Pharmacy Benefits

Amphetamine salts, methylphenidate, and other generics typically covered

Yes - All Plans

Brand ADHD Medications

CPT Code: Pharmacy Benefits

Vyvanse, Concerta, Adderall XR - may require prior authorization

Usually Covered

Our Insurance Support

We handle the insurance details so you can focus on your health

Coverage Verification

We verify your insurance coverage, deductible status, copay amounts, and out-of-pocket maximums before your appointment

Prior Authorization

We handle all prior authorization requests with your insurance company to ensure smooth approval

Transparent Pricing

You'll know your exact copay and costs in advance - no surprise bills or unexpected charges

Billing Support

Our experienced billing team works with your insurance to maximize benefits and minimize your out-of-pocket costs

Out-of-Network Options

Even if we're out-of-network for your plan, we can help with superbills for reimbursement

Payment Plans Available

If you need to cover your deductible or out-of-pocket costs, we offer flexible payment arrangements

How to Verify Your Benefits

Simple 4-step process to understand your coverage

1

Call Us

Contact our billing team at 678-437-1659 with your insurance card information

2

We Verify Benefits

We'll contact your insurance company to verify coverage, deductible, and copay amounts

3

Review Your Benefits

We'll explain your coverage details, what's included, and any out-of-pocket costs

4

Schedule & Confirm

Schedule your appointment with full knowledge of your costs - no surprises at the visit

Ready to Get Started?

Call our billing team today to verify your benefits and schedule your ADHD evaluation

Call 678-437-1659

Payment Options

Flexible payment methods for every situation

Insurance Copay

Pay your copay at the time of service

Most affordable option

Deductible Payment Plans

Spread your deductible across multiple payments

For high-deductible plans

HSA/FSA Accounts

Use pre-tax health savings for treatment and medications

Save 20-30% in taxes

Out-of-Network Superbill

We provide superbills for out-of-network reimbursement

Reimburse on your own schedule

Out-of-Network Options

If we're out-of-network for your insurance plan, we can still help you access our services and maximize reimbursement.

  • Superbills Provided

    We provide detailed superbills for you to submit to your insurance for reimbursement

  • Reduced Rates

    We offer discounted rates for out-of-network patients

  • Payment Plans Available

    Flexible payment options to make care affordable

Uninsured Patients

We offer affordable options for patients without insurance coverage.

  • Sliding Scale Fees

    Fees starting at $300 for evaluation based on income

  • Payment Plans

    Split treatment costs across multiple monthly payments

  • Medication Assistance

    Free medications through pharmaceutical programs if eligible

HSA & FSA Eligible

Save money on ADHD care with tax-free health accounts

ADHD evaluations, medication management visits, and medications are all eligible for Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA). Using these accounts provides immediate tax savings of 20-30% on your out-of-pocket costs.

Initial Evaluation
$300-500
HSA/FSA eligible
Monthly Medications
$10-75
Save 20-30% with HSA/FSA
Follow-up Visits
$100-200
Use pre-tax dollars

Frequently Asked Questions

What insurance plans do you accept?

We accept Medicare, Medicaid, Aetna, Blue Cross Blue Shield (BCBS), Cigna, UnitedHealthcare, Humana, and Anthem. If your insurance is not listed, please call us at 678-437-1659 to verify coverage.

How can I verify my insurance benefits?

Call our billing team at 678-437-1659 before your appointment. We'll verify your coverage, deductible, copay amounts, and out-of-pocket maximums. You can also check your insurance portal or call your insurance company directly with your policy number.

What CPT codes are covered for ADHD evaluation?

ADHD evaluations are typically covered under CPT codes 99213-99215 (office visits) and 96116 (computerized testing/TOVA). ADHD medication management is covered under 99213-99215 for follow-up visits. Coverage varies by plan and medical necessity.

What if I don't have insurance?

We offer flexible payment plans for uninsured patients. Our sliding scale fees start at $300 for initial evaluation and $100 for follow-up visits. We also accept HSA/FSA funds. Call 678-437-1659 to discuss options.

Are ADHD medications covered by insurance?

Yes, most insurance plans cover ADHD medications. Generic stimulants (amphetamine salts, methylphenidate) are typically $10-30/month with insurance. Brand-name medications have copays of $30-75/month. Many manufacturers offer copay assistance cards reducing costs further.

Can I use HSA or FSA accounts for ADHD treatment?

Yes, ADHD evaluations, medication management visits, and medications are eligible for tax-free HSA and FSA spending. Using these accounts provides 20-30% tax savings on your treatment costs.

Ready to Start Your ADHD Evaluation?

Let us handle the insurance details. Call today to verify your benefits and schedule your comprehensive ADHD evaluation

Schedule Appointment