Financial and Insurance Information

 
 

Covered Insurance Plans

Madison Neuropsychological Services is in-network with the following health insurance providers: 

  • SSM Health/Dean

  • Quartz HMO

  • We are not in-network with Medicare, United Healthcare, Cigna, Aetna, Tricare, Anthem Blue Cross Blue Shield, or GHC. However we do have an out of network payment option. See below for more information about this option.

  • We are not currently accepting Medicaid (including ForwardHealth and Badgercare plans).

Doctor’s Referral Required for Neuropsychological Assessment

In order to utilize HMO/insurance billing, an MD referral is required and can be sent to our fax number (608-492-2573). Please note that this does not apply to psychotherapy services.

Verify with Your Insurance

Even though MNS has been approved as an in-network provider with the above insurance carriers, you may still be responsible for out-of-pocket payments, depending on your individual plan. Please contact your insurance carrier for an estimate of benefits because MNS does not verify individual insurance benefits. It is the responsibility of each patient/guarantor to ensure psychotherapy services and/or neuropsychological assessment is covered PRIOR to your appointments. You are strongly encouraged to contact your insurance company to determine the details of your coverage prior to your appointment.

CPT billing codes for that we use for

  • Neuropsychological Evaluation: include 96116 (1 unit), 96121 (1 unit), 96136 (1 unit), 96137 (11 units), 96132 (1 unit), and 96133 (5 units).

  • Psychotherapy Services: billing codes typically used for therapy include: 90791, 90834, 90837, 90785, 90846, 90847, 90839.

Private/Cash Payment

For psychotherapy services, we offer a private pay option that costs $250 for an intake appointment (1 hour); $150 for individual therapy session (50 minutes) and $200 for couples/family therapy session (1 hour).

For neuropsychological assessment services, MNS offers a private pay option that costs between $3,000-$3,500 depending on the case complexity. This fee includes all three appointments; intake, testing, feedback and the report. Our policy is that the patient pays up-front and then we will provide a detailed invoice that can be submitted back to insurance for reimbursement. The patient is responsible for this process and we strongly recommend verifying if your insurance company will reimburse for out-of-network services, before the appointment. Please contact us if you have further questions regarding this option.

Academic Testing

Insurance companies have deemed academic achievement testing not to be medically necessary. You may be able to access academic testing through your public school district free of charge. Should you elect to pursue academic testing through Madison Neuropsychological Services you will incur additional out-of-pocket costs. The fee for academic testing is $750 and cannot be submitted back to any health insurance company. Academic Testing at MNS is only offered after a neuropsychological evaluation has been completed. Your provider will inform you if additional academic testing is recommended and you will have the opportunity to agree or decline at that time.