What to know: Most commercial insurance plans cover adult ADHD evaluation and treatment when it's done by a psychiatric clinician as a medical visit. Full neuropsychological testing is covered less consistently. Under U.S. mental health parity law, plans that cover mental health must cover it comparably to medical care.
What's usually covered
- Psychiatric evaluation for ADHD
- Ongoing medication management visits
- Therapy, such as CBT for ADHD, anxiety, or depression
- Telehealth visits, under most commercial plans
What's often not covered, or only partly
- Full neuropsychological testing (sometimes needs prior authorization)
- Out-of-network providers, unless you have out-of-network benefits
- Coaching services that aren't delivered by a licensed clinician
How to check your coverage
- Call the number on the back of your insurance card.
- Ask about outpatient mental health or behavioral health benefits.
- Ask whether the provider is in network, and what your copay, coinsurance, and deductible are.
- Ask if telehealth visits are covered the same way as in-person visits.
Or ask the practice to check for you. Many practices, including PracticeRx, will verify benefits before your first visit.
What about out-of-network care?
If your plan has out-of-network benefits, you may be reimbursed for part of the cost after paying the provider directly. Ask your plan for your out-of-network deductible and reimbursement rate.
Frequently asked questions
Does Medicare cover adult ADHD treatment? Medicare covers outpatient mental health care, but individual practices may not accept it. Ask the practice directly.
Will an ADHD diagnosis affect my insurance? Under the Affordable Care Act, health plans can't deny coverage or charge more based on pre-existing conditions.
Is therapy for ADHD covered? Usually, when it's delivered by a licensed clinician as part of treatment.
Insurance at PracticeRx
PracticeRx accepts commercial insurance for psychiatry and therapy, including adult ADHD, anxiety, and OCD care. Care is available in person in Scottsdale, AZ and via telehealth in Arizona, New York, Kansas, Minnesota, Oregon, and Washington.
This article is educational and not a substitute for individualized medical or insurance advice.
