When deciding upon a neurofeedback provider, keep in mind that only licensed professionals may give you a receipt to file with your insurance company. And most insurance companies will pay for at least the first two visits (initial consultation and testing/evaluation appointments).
The first step in determining the potential for using neurofeedback training in your treatment is to schedule an initial consultation with one of our therapists. During this 50 minute session, we will determine whether you are a viable candidate for neurofeedback therapy, if you should consider treatments other than neurofeedback, or whether a combination of treatments should be considered. During this time you will have the opportunity to experience a demo neurofeedback session. You will also have the opportunity to ask our therapists any additional questions you may have. The fee for the initial consultation is $150 and is often reimbursed to you by insurance.
Evaluation, Testing and Brainmap
If Neurofeedback is considered appropriate for you the next step would be for you to be scheduled for an evaluation, testing and brainmap. It is desirable to complete testing without any stimulants so if you are able to discontinue caffeine for 5 days prior to testing, this is optimal. If you or your child are on stimulants (such as Ritalin, Concerta, Dexadrine, or Adderal), testing can be done in the morning before the morning dose is taken. Also, please wash and dry your hair within 12 hours of the evaluation so that the electrodes will adhere properly during the brainmap. The evaluation, testing and brainmap takes 2.5 – 3 hrs. and must be done in the morning. The fee for this session is $500 and this is often at least partially covered by insurance.
After the evaluation, the Neurofeedback sessions can then be scheduled. They are scheduled in blocks of 20 and should be done at least twice weekly. Sessions are approximately 45 minutes long. The average number of sessions is 40-50 with some conditions responding before 40; others are more difficult and require 60 to 100. Some individuals will begin to notice changes after just a few sessions, but in some of the more complicated cases, major benefit will not be noted until after 60 or more sessions. Please expect to undergo at least 40 sessions. Although it is likely that improvements will be noticed before 20 sessions they may not be sustained without continued sessions. There appears to be a cumulative benefit of the number of sessions undergone. Neurofeedback sessions are $150 per session if paid after each session. If prepaid in advance for 21 sessions, the discounted fee per session comes to $142.50. A 5% discount is applied to advance payments of 21 sessions (20 neurofeedback sessions @142.50 plus one re-TOVA test @ $150) for a total of $3000.00 with a 5% prepayment savings of $150.00 (non-discounted fee would be $3150.) Please see the questions below for your insurance company.
If this test is recommended by our therapists, it takes two hours and costs $950. This includes two reports (one from a neurologist) and protocol recommendations. This procedure may be covered by your insurance.
Testing includes administration, materials, written report, and 1-2 hour feedback session. A complete neuropsychological assessment is usually conducted over three to four days depending on the child’s pace and age. Testing for accommodations (SAT, for example) usually takes two days (2-4 hours per day). All other individualized testing is charged based on the hourly fee of $150.
Health Insurance Coverage
If you have a health benefits policy, you can explore the possibility of coverage. The insurance company may reference this as a CPT code 90901 (biofeedback by any modality) or 96152 (Health and Behavioral Intervention incorporating Biofeedback). If your insurance company will authorize training, we ask that you pay for services and apply for reimbursement. A statement will be provided for your convenience in submitting claims.
Questions to Ask Your Health Insurance Company
1. Does my policy cover biofeedback (Code 90901 or 96152) for my diagnosis of _________ and/or ________?
2. If yes, is it covered under Medical or Psychological Services?
3. What rate is reimbursed since the therapists at The Better Brain center are out of network (e.g. 80% of usual and customary for in network vs. 50% of usual and customary for out of network providers)
4. If it is covered under Medical Services, do I need a prescription or letter from my MD to say that it is medically necessary?
5. How many sessions of biofeedback will you cover? Per week? Per year?
6. Is there a limit of total amount paid out? (i.e., caps out at $1500 each year)
7. Since The Better Brain Center therapists are out of network providers, do I need to see my primary care physician to make a referral to her?