Looking for a Neuropsychological Evaluation?

If your physician, therapist, school, or another healthcare provider has told you to “get a neuropsychological evaluation,” you may be wondering exactly what that means. What will you be tested for? What tests will be administered? How long will it take? And will your insurance cover it?

One of the most important things to understand is that a neuropsychological evaluation is not one specific type of evaluation or one standard set of tests. Instead, the term is often used as a broad umbrella to describe many different types of evaluations that examine cognitive functioning along with emotional, behavioral, developmental, or academic concerns.

Physicians frequently refer patients for a “neuropsychological evaluation” without specifying exactly what type of testing is needed. The actual evaluation should be determined by the person’s age, symptoms, history, concerns, and, most importantly, the questions the evaluation is intended to answer.

What Does a Neuropsychological Evaluation Measure?

Depending on the reason for testing, an evaluation may examine intellectual functioning, memory, attention, executive functioning, processing speed, language, visual-spatial abilities, academic achievement, social functioning, and emotional or behavioral symptoms.

There is no single “neuropsychological test,” and every patient does not need every available test. A well-designed evaluation is individualized. The clinician determines what questions need to be answered and then selects the appropriate combination of tests and other assessment tools.

There are several common reasons children, adolescents, adults, and older adults may be referred for this type of testing.

Learning Disability and Psychoeducational Evaluations

A learning disability evaluation, often referred to as a psychoeducational evaluation, examines how an individual learns and whether specific difficulties are affecting reading, writing, mathematics, or other academic skills.

Testing may examine cognitive abilities and academic achievement to identify patterns of strengths and challenges. These evaluations can help identify conditions such as dyslexia, dysgraphia, and dyscalculia and may provide documentation to support appropriate accommodations or interventions at school, college, or on standardized examinations.

ADHD Evaluations for Children and Adults

An ADHD evaluation looks beyond whether someone is simply distracted, forgetful, disorganized, or has difficulty sitting still.

Depending on the individual, testing may examine sustained attention, working memory, processing speed, executive functioning, organization, impulse control, and behavioral symptoms. Because anxiety, depression, sleep difficulties, learning disabilities, and other conditions can sometimes look like ADHD, a comprehensive evaluation can also help determine whether another condition better explains the symptoms or whether multiple conditions are occurring together.

ADHD evaluations can be appropriate for both children and adults, including adults who have struggled with attention, organization, procrastination, or time management for years without ever receiving a formal diagnosis.

Autism Evaluations for Children and Adults

An autism evaluation may examine social communication, relationships, restricted or repetitive behaviors, sensory differences, developmental history, and everyday functioning.

Autism evaluations can be completed for children, adolescents, and adults. Adult evaluations can be particularly valuable for people who have spent years wondering why social situations, relationships, sensory experiences, or certain aspects of everyday life seem more difficult for them than for others.

Because autism can present differently from one person to another, comprehensive testing can help distinguish autism from conditions that may share certain characteristics, including ADHD, anxiety, and other developmental or emotional concerns.

Memory, Cognitive Decline and Dementia Evaluations

When an adult or older adult begins experiencing memory loss, confusion, difficulty finding words, changes in judgment, or difficulty completing familiar tasks, a physician may recommend testing for cognitive decline or possible dementia.

Testing may examine memory, attention, language, executive functioning, processing speed, reasoning, visual-spatial skills, and other cognitive abilities. The goal is often to identify patterns of cognitive strengths and weaknesses and determine whether additional medical investigation or treatment may be appropriate.

The results can also provide valuable information to physicians and families when making decisions about treatment, support, safety, independence, and future planning.

Dementia is not a single condition. A comprehensive evaluation examines memory, attention, language, executive functioning, processing speed, and other cognitive abilities to help determine the likely source of dementia or cognitive decline. Different types include:

• Alzheimer’s disease – often associated with progressive memory loss and difficulty learning new information.
• Vascular dementia – cognitive changes related to reduced blood flow or damage to blood vessels in the brain.
• Lewy body dementia – may involve changes in thinking, alertness, movement, sleep, and visual perception.
• Frontotemporal dementia (FTD) – often affects personality, behavior, judgment, or language.
• Parkinson’s disease dementia – cognitive decline that develops in individuals with Parkinson’s disease.
• Mixed dementia – occurs when more than one type of dementia is present.

Identifying the pattern of cognitive strengths and weaknesses can help physicians clarify the diagnosis, determine whether additional medical testing is needed, and develop an appropriate treatment and care plan.

Intellectual and Cognitive Functioning Evaluations

Sometimes the primary question involves a person’s overall cognitive or intellectual functioning.

Testing may examine verbal reasoning, visual-spatial abilities, working memory, processing speed, problem-solving, and other cognitive skills. These evaluations can identify areas of strength as well as areas in which an individual may need additional support.

Cognitive testing may be completed independently or included as one component of a larger evaluation for ADHD, learning disabilities, autism, cognitive decline, or another concern.

Executive Functioning Evaluations & Gifted Testing

Executive functioning refers to the mental skills we use to plan, organize, prioritize, manage time, remember instructions, regulate impulses, and complete tasks.

Difficulties with executive functioning can occur with ADHD, learning disabilities, autism, neurological conditions, and other concerns. Testing can help identify which specific executive skills are creating difficulties at school, work, or home and provide recommendations for improving day-to-day functioning.

Emotional and Behavioral Evaluations

Cognitive symptoms do not always have a purely cognitive explanation.

Anxiety, depression, trauma, stress, and other emotional or behavioral concerns can affect concentration, memory, motivation, academic performance, work performance, and everyday functioning. For this reason, comprehensive evaluations may also include measures of emotional and behavioral functioning.

Looking at these areas together can help provide a more complete picture of why someone is struggling, rather than simply identifying the symptoms they are experiencing.

Why Did My Doctor Just Say “Get a Neuropsychological Evaluation”?

This is extremely common.

A pediatrician, neurologist, psychiatrist, primary-care physician, or other healthcare provider may recognize that additional testing is needed but simply provide a referral stating “neuropsychological evaluation.”

That does not necessarily tell the testing provider which evaluation should be performed.

A qualified provider should review the referral, speak with the patient or parent, consider the person’s symptoms and history, and determine what type of evaluation and combination of tests will best answer the referral question.

In other words, the evaluation should be designed around the patient—not the other way around.

Does Insurance Cover Neuropsychological Evaluations?

The answer is: sometimes.

Insurance coverage depends on the patient’s specific plan, the reason for testing, the symptoms or diagnosis being investigated, medical necessity requirements, the tests being administered, and whether the provider participates with the patient’s insurance company.

Many practices that provide comprehensive evaluations do not accept insurance for these services. Testing involves considerably more professional time than the hours a patient actually spends completing tests. There may be clinical interviews, record review, test selection, test administration, scoring, interpretation, report writing, consultation, and a feedback appointment.

Insurance authorization requirements and reimbursement for all of this professional work can make providing comprehensive testing through insurance difficult. As a result, many practices provide these evaluations exclusively on a self-pay basis.

The cost of a comprehensive self-pay evaluation varies considerably depending on its scope and complexity, but patients may encounter prices of approximately $2,500 to $5,000 or more.

Making Comprehensive Evaluations More Affordable

At Plantation Counseling & Wellness, we believe that cost should not automatically prevent individuals and families from obtaining the answers they need.

Rather than requiring every patient to pay the entire cost of an evaluation out of pocket, we work with insurance whenever possible to have the insurance company cover a substantial portion of eligible evaluation services.

Coverage varies by insurance plan and by the purpose and type of evaluation, and not every component of testing is necessarily covered. However, utilizing available insurance benefits can significantly reduce the amount families ultimately pay themselves.

Looking for Neuropsychological Testing Covered by Insurance?

Finding neuropsychological testing that is covered by insurance can be surprisingly difficult. Many practices that provide comprehensive testing do not participate with insurance companies for these services, leaving patients responsible for the entire cost.

At Plantation Counseling & Wellness, we take a different approach. We work with insurance companies whenever possible to have eligible portions of an evaluation covered under the patient’s benefits.

Although every insurance plan is different and coverage cannot be guaranteed, the majority of our patients who are able to use their insurance benefits pay approximately $400 to $1,300 out of pocket for their evaluation, rather than the $2,500 to $5,000 or more that comprehensive self-pay testing may cost.

The exact amount depends on several factors, including the type and complexity of the evaluation, the patient’s insurance benefits, deductible and coinsurance, and which components of the evaluation are covered by their plan.

Our goal is to maximize available insurance benefits whenever possible while still providing the comprehensive testing necessary to answer the questions that brought the patient to us in the first place.

This approach can make formal testing considerably more accessible for children, adolescents, adults, and older adults seeking answers about ADHD, autism, learning disabilities and dyslexia, memory loss and cognitive decline, executive functioning difficulties, and other cognitive, emotional, developmental, or behavioral concerns.

Finding the Right Evaluation Starts With the Right Question

If someone tells you that you or your child needs a “neuropsychological evaluation,” don’t be intimidated by the terminology.

Remember that neuropsychological evaluation is a broad umbrella term. It does not refer to one particular test, one standard battery of tests, or one particular diagnosis.

The appropriate evaluation depends on what you are trying to understand.

Are you trying to determine why your child is struggling to read despite being bright and working hard? Are you an adult who has wondered for years whether ADHD or autism could explain lifelong difficulties? Have you noticed changes in a parent’s memory or thinking? Are you trying to understand why attention, organization, or executive functioning has become a problem?

Those are very different questions—and they require different approaches to testing.

The most important question isn’t simply:

“Where can I get a neuropsychological evaluation?”

It is:

“What are we trying to understand?”

Once that question is clear, the appropriate evaluation can be designed to provide meaningful answers, identify strengths as well as challenges, and provide recommendations for what to do next.