Pricing & Insurance Options

We believe in complete financial transparency. Below you will find clear guidance on our contracted insurance networks, private pay options, and out-of-network benefit support.

Verify Your Eligibility

Pricing and Insurance visual timeline and framework

🧭

In-Network Insurance

We partner with select major insurance networks in Illinois to help make late-identified autism evaluations more accessible.

🌸

All-Inclusive Cash Rate

A simple, transparent flat-fee structure designed for clients who choose to bypass insurance entirely.

✨

Upfront Verification

We verify your personal mental health and testing benefits in advance.

Pathway 1

In-Network Insurance (Illinois Residents)

If you are a resident of Illinois and carry an active commercial plan with one of our contracted networks, we can bill your insurance company directly.

Accepted In-Network Payers:

Blue Cross Blue Shield of Illinois (BCBSIL) PPO
Aetna Commercial Plans
Medicare

🔒 Personalized Insurance Benefit Check

Due to commercial insurance network regulations, exact contracted reimbursement schedules are kept private and cannot be published on our public website. However, we are fully committed to helping you understand your specific coverage.

Once you submit a request for a secure portal invite, our administrative team will perform a comprehensive benefit verification. We will check your outpatient mental health benefits, confirm if your specific policy requires a prior authorization for psychological evaluation codes, and provide you with a detailed, private breakdown of any expected out-of-pocket costs (such as deductibles, co-pays, or co-insurance) before we schedule your clinical interview.

*Please note: We do not participate in HMO networks or Medicaid managed care programs at this time.

Pathway 2

All-Inclusive Cash Rate (Out-of-State / Self-Pay)

Designed for individuals residing in PSYPACT member states, out-of-network clients, or those who prefer a private diagnostic evaluation without submitting clinical files to an insurance carrier.

Standard Package Fee:
$1,200.00

What is Fully Covered in Your Package:

Pre-visit developmental records review & administrative setup.
Access to our secure, HIPAA-compliant patient portal.
Advanced digital developmental and sensory diagnostic questionnaires.
two 90-minute live, interactive video consultation with Dr. Jansons.
Rigorous post-visit diagnostic integration and DSM-5-TR criteria mapping.
A comprehensive, professional written diagnostic report.
30-minute telehealth feedback session to review results, outline clinical answers, and walk through next steps.
Access to our curated, neurodiversity-affirming community resource and accommodation guide.

Transparent Payment Schedule:

$200.00 non-refundable deposit: Processed at portal registration to cover your clinical intake triage, administrative processing, and secure file setup.
$1,000.00 remaining balance: Processed automatically prior to your live 90-minute clinical interviews.

🧾 Out-of-Network Superbills

Seeking reimbursement utilizing out-of-network mental health benefits.

If you are self-paying for your evaluation but hold out-of-network mental health coverage, we are happy to provide you with a detailed, itemized clinical receipt (a Superbill) at the end of your evaluation episode. You can submit this document directly to your insurance provider to request potential out-of-network reimbursement.

✓ Superbill provided ✓ Reimbursement support ✓ Detailed billing receipts ✓ Standard CPT code mapping

💡 Recommended First Step

Verify your out-of-network benefits: Before starting, we highly encourage you to call the member services phone number on the back of your insurance card. Ask if your plan reimburses out-of-network, telehealth-delivered psychological testing services (specifically CPT codes 90791, 96130, 96131, 96136, and 96137, billed with the 95 modifier for interactive video). This will give you full coverage expectations in advance.

Billing & Insurance FAQs

Does insurance cover the full cost of my diagnostic evaluation?

If you are an Illinois resident carrying Blue Cross Blue Shield of Illinois (BCBSIL) PPO, Aetna commercial plans, or Medicare, your insurance will typically cover a significant portion of the evaluation. However, coverage depends on your specific outpatient mental health benefits, unmet deductibles, and co-insurance rates. We verify these exact details prior to your interactive clinical session so there are no financial surprises.

What specific billing codes (CPT codes) will be on my Superbill?

Your clinical Superbill will list standard, AMA-approved time-based evaluation and testing codes. Typically, this includes:

90791: Diagnostic Intake Interview
96130 & 96131: Psychological Evaluation, Interpretation, and Report Prep
96136 & 96137: Standardized Test Administration & Scoring

All telehealth codes are billed with the 95 modifier indicating secure interactive video.

Do you require a prior authorization before we begin?

Some insurance plans (particularly certain BCBSIL and Aetna products) require a pre-service clinical authorization for psychological testing codes before we can begin. As part of our intake process, our office will determine if your plan requires a prior authorization and will handle the clinical submission for you to streamline your scheduling.

What is your cancellation and rescheduling policy?

Because we reserve dedicated multi-hour clinical blocks for your diagnostic interviews, we require at least 24 business hours’ notice to reschedule or cancel a session. Missed sessions or late cancellations are subject to a $150.00 fee. Additionally, please note that all fees purchase our rigorous professional evaluation time and diagnostic opinion; they do not purchase or guarantee a specific diagnosis.

Fees and Insurance