Neurodevelopmental Evaluation Services

VCARDD and its trusted consultants provide multidisciplinary, comprehensive evaluations  for children, adolescents and adults who are suspected of having Autism or other neurodevelopmental disorders as defined by the DSM 5© . This service is designed to meet the needs of individuals who have not been previously diagnosed, or for those who wish to have a previously diagnosed neurodevelopmental disorder re-evaluated.  We go beyond diagnosis to offer management and supportive services for patients, parents, other caregivers and social agencies.
Early diagnosis leads to early intervention, which in turn leads to better outcomes. The effective treatment of neurodevelopmental disabilities has and always will encompass incorporating the best modalities from many disciplines. No single discipline has “all the answers.” Each evaluation is tailored the individual patient’s needs- there is no set process in this office. Reimbursement will be addressed after the first appointment.

Comprehensive Behavioral Intervention for Tics (CBIT)

In addition to Evaluation Services, we provide treatment for Tourette Syndrome and Tic Disorders.  For more information on this service, see this Web site: https://www.tourette.org/research-medical/cbit-overview/.

What is the evaluation process?
1. The first appointment in the evaluation process begins with a review of concerns by a health care professional.  During this visit, written histories are completed and all pertinent records reviewed. A physical and/or neurological examination is conducted, and appropriate tests and consultations are ordered. A follow up appointment is scheduled.
2. At the second appointment, reports received to date are reviewed. More in depth testing may be ordered.
3. At a third appointment, a diagnosis is made (or deferred) and a treatment plan is outlined in a comprehensive report.  Distribution of the report is at the discretion of the recipient. A follow up appointment is made usually within one to three months.
4. Ongoing management (or support) appointments occur a minimum of one to twelve months after the last evaluative appointment.

Evaluation Tests or Instruments

A variety of diagnostic tests or measures are used when assessing neurodevelopmental  disorders. These tests depend on the age, developmental level, and communication skills of the patient. Neuroimaging, neurophysiologic and neurogenetic testing may include standard MRI, sleep deprived EEG and/or cytogenetic studies. Neuropsychological testing typically assesses intellectual skills, academic skills, speech and language skills, motor coordination skills, and Neurocognitive skills.  In addition, rating scales completed by parents/guardians, teachers, and if appropriate, an adolescent or the patient him/herself may be employed.

Evaluation Costs

Approximately:  $2500
The cost of the evaluation covers the interviews, examinations, a review of the developmental history and school records*, administration of the diagnostic measures, scoring of the measures, interpretation of the test findings, report write-up, and a summary conference.

• 1 initial assessment interview ($250.00, CPT code 90791).
• 1 therapeutic interview, ($150.00, CPT code 90846).
• 1 therapeutic interview, ($150.00, CPT code 90834).
• 4 hours of psychometric or autism specific testing ($1500.00), which may or may not be covered through insurance.
• 4 hours of educational testing (950.00), which is not covered through insurance.
• 1 review summary ($150.00), which is not covered through insurance.
• Payment for non-insurance covered services is expected at the time of each appointment.  Should you need to finance the cost of the non-insurance covered services, payment may be made over a three-month period or longer through the use of CareCredit.  You may contact them at 800 677-0718 or review their website at www.carecredit.com
• Testing performed by other agents, such as electroencephalogram, genetics testing, and imaging studies are billed by the providers of these services.

Figures in bold indicate minimum out of pocket expenses.

* If a review of records exceeds one (1) hour, an additional charge will be added at a rate of $150.00 per hour in quarter-hour increments, which is not covered through insurance.

In order to verify your coverage, check with your insurance company.  In addition, the VCARDD business office staff can also assist you with providing an estimate of the final out-of-pocket expenses associated with the evaluation. 

Scheduling and Further Questions

If you suspect that you, your child or adolescent may have a Neurodevelopmental or Autism Spectrum Disorder and would like to schedule an initial insurance-covered appointment, please contact VCARDD at (804) 673-9600. These evaluations are complex, and are individualized to each patient’s needs- there is no “cookie-cutter” workup.  It will be difficult for our support staff to answer many of your questions.  Make a written list for discussion at your first appointment.  Again, we will tailor our evaluation and management process to your individual situation.  

The array of conditions we diagnosis and treat are taken from the Diagnostic and Statistical Manual 5© of the American Psychiatric Association with ICD 9-10 codes are listed below:

Neurodevelopmental Disorders

319                                          Intellectual Disability
                                                 Specify current severity:
                             (F70)         Mild
                             (F71)          Moderate
                             (F72)          Severe
                             (F53)          Profound
315.8                   (F88)          Global Developmental Delays
319                      (F79)           Unspecified Intellectual Disability
                                                 (Intellectual Developmental Disorder)

Communication Disorders

315.39              (F80.9)          Language Disorder
315.39              (F80.0)          Speech Sound Disorder
315.35              (F80.81)        Childhood-Onset Fluency Disorders (Stuttering)
                                                  Note: Later-onset cases are diagnosed as 307.0 (F98.5)   adult-onset fluency                                                                                 disorder.
315.39              (F80.89)       Social (Pragmatic) Communication Disorder
307.9                (F80.9)         Unspecified Communication Disorder 

Autism Spectrum Disorder

299.00              (F84.0)        Autism Spectrum Disorder
Specify if:                                Associated with a known medical or genetic condition or environmental  factor;                                                                                 Associated with another neurodevelopmental, mental, or behavioral disorder
                                                  Specify current severity for Criterion A and Criterion B:  Requiring very substantial                                                                       support, requiring substantial support, requiring support
                                                  Specify if: With or without accompanying intellectual impairment, with or without                                                                       accompanying language impairment, with catatonia (use additional code 293.89                                                                                 [F06.1])

Attention-Deficit/Hyperactivity Disorder

314.01           (F90.2)          Combined presentation
314.00          (F90.0)          Predominantly inattentive presentation
314.01           (F90.1)           Predominantly hyperactive/impulsive presentation
                                               Specify if: In partial remission
                                               Specify current severity:  Mild, Moderate, Severe
314.01           (F90.8)         Other Specified Attention-Deficit/Hyperactivity Disorder (65)
314.01           (F90.9)         Unspecified Attention Deficit/Hyperactivity Disorder (66)

Specific Learning Disorder

315.00           (F81.0)          With impairment in reading (specify if with word reading accuracy, reading rate or                                                                              fluency, reading comprehension)

315.2             (F81.81)         With impairment in written expression (specify if with spelling accuracy, grammar and                                                                    punctuation accuracy, clarity or organization of written expression)

315.1             (F81.2)           With impairment in mathematics (specify if with numbers sense, memorization of                                                                              arithmetic facts, accurate or fluent calculation, accurate math reasoning)
                                               Specify current severity:   Mild, Moderate, Severe

Motor Disorders

315.4             (F82)             Developmental Coordination Disorders (74)
307.3            (F98.4)          Stereotypic Movement Disorder (74)
                                              Specify if: With  self-injurious behavior, Without self-injurious behavior
                                              Specify if: Associated with a known medical or genetic condition,  neurodevelopmental                                                                   disorder, or environmental factor
                                              Specify current severity: Mild, Moderate, Severe

Tic Disorders

307.23          (F95.2)           Tourette’s Disorder  (81)
307.22          (F95.1)           Persistent (Chronic) Motor or Vocal Tic Disorder (81)
                                               Specify if:  With motor tics only, With vocal tics only
307.21          (F95.0)           Provisional Tic Disorder (81)
307.20         (F95.8)           Other Specified Tic Disorder (85)
307.20         (F95.9)           Unspecified Tic Disorder  (85)

Other Neurodevelopmental Disorders (86)

315.8           (F88)              Other Specified Neurodevelopmental Disorder (86)
315.9           (F89)              Unspecified Neurodevelopmental Disorder        (86)