A straight answer on private pay pricing, what insurance does and does not cover, and where the free options actually exist.
There is no single price for an autism evaluation, because "autism evaluation" describes several different things. A full neuropsychological battery at a private practice, a developmental assessment at a hospital clinic, and a telehealth diagnostic evaluation are all sold under the same phrase and priced very differently.
Broadly, comprehensive neuropsychological testing sits at the top of the range and can run into several thousand dollars. Hospital and academic developmental clinics vary enormously depending on your coverage and can be close to free or very expensive. Telehealth diagnostic evaluations generally sit at the lower end of the private pay range.
Foyer charges $1,499, flat, paid at intake, for three virtual visits and a complete DSM-5 diagnostic report. No copays, no add-on report fee, no pre-authorization.
How much testing is included. A cognitive battery, an academic achievement battery, and a memory and processing assessment each add hours of clinician time. If the question in front of you is specifically whether your child is autistic, a full neuropsychological battery is often more than the question requires.
Who performs it. Physician, psychologist, and multidisciplinary team evaluations are priced differently, and a multidisciplinary team is the most expensive by a wide margin.
Whether the report is bundled. Some practices quote a testing fee and charge separately for the written report. That is the most common source of a surprise bill in this category. Ask before you book.
Whether insurance is involved. Billing insurance does not make an evaluation cheaper by default. It shifts the cost into your deductible and coinsurance, and it adds a prior authorization step that is frequently what creates the wait in the first place.
Therapy authorization, school supports, and early intervention services all depend on a documented diagnosis. While the evaluation is pending, none of them can start. For a young child, a twelve month wait is a twelve month delay in access to intervention during the window where it matters most.
That is the actual comparison. Not $1,499 against $0, but $1,499 now against a covered evaluation that may not happen for a year.
Private pay costs vary widely by setting. Comprehensive neuropsychological testing at a private practice is typically the most expensive option and commonly runs into the thousands. Telehealth diagnostic evaluations are generally the lower end of the private pay range. Foyer charges a flat $1,499 for the complete evaluation with no add-on fees.
Usually yes in principle, but what you actually pay depends on your deductible, your coinsurance, and whether the evaluator is in network. Prior authorization is frequently required, and the authorization process is one of the main reasons evaluation waitlists run as long as they do. Call your plan before booking anywhere and ask specifically about diagnostic evaluation coverage and prior authorization.
Yes. A diagnostic evaluation is a qualified medical expense, so HSA and FSA funds can be used at booking.
A superbill is an itemized receipt with diagnostic and procedure codes that you submit to your insurer yourself. Families with PPO or out-of-network benefits often recover a meaningful portion of the fee. Families on HMO or Medicaid plans generally will not, because those plans usually do not reimburse out-of-network care at all. We provide the superbill either way, but we cannot promise what your plan will do with it.
Sometimes. If your child is under three, your state's Early Intervention program provides free developmental evaluation, though it produces an eligibility determination rather than a medical diagnosis. If your child is in school, the district is obligated to evaluate at no cost when a special education referral is made, which again produces an educational classification rather than a medical diagnosis. If your child has Medicaid, the EPSDT benefit covers diagnostic evaluation for children under 21. These paths are real and worth pursuing. They are also usually the slowest.
$1,499 covers three virtual visits, the standardized clinical assessment, the comprehensive DSM-5 diagnostic report, a personalized care plan, and an itemized superbill. HSA and FSA eligible. There is no separate report fee and no charge for the findings visit.
Full detail is on the pricing page, and the three visit structure is laid out on how it works.
Clinically reviewed by Dr. Selena Levine, DO, board-certified pediatrician. This page is general information, not medical advice, and it is not a diagnosis.
Three visits, two to four weeks, $1,499 all in.