Cape Cod Psychology offers insurance-based and private-pay neuropsychological evaluations. The scope of an evaluation depends on the referral question, medical necessity, the individual’s insurance coverage, and the type of information needed.

Cape Cod Psychology is an in-network provider with Blue Cross Blue Shield of Massachusetts.

Blue Cross Blue Shield may cover psychological or neuropsychological testing when the evaluation is medically necessary to answer a specific diagnostic or treatment-planning question that cannot be adequately resolved through interview, routine treatment, or previously completed testing.

An insurance-based evaluation is focused on the medical and diagnostic questions submitted to Blue Cross Blue Shield. It generally includes a clinical interview, review of relevant records, targeted testing, scoring and interpretation, a written clinical report, and one feedback meeting.

Insurance coverage does not automatically include comprehensive educational testing, gifted-program testing, school-placement decisions, IEP development, attendance at school meetings, legal or forensic opinions, vocational planning, or other services performed primarily for educational, legal, or administrative purposes.

Prior authorization may be required depending on the member’s plan. Verification of benefits or authorization does not guarantee payment. Families remain responsible for any deductible, copayment, coinsurance, or other amount assigned by their insurance plan.

Cape Cod Psychology accepts traditional Medicare Part B for medically necessary neuropsychological evaluation of suspected memory loss, cognitive decline, mild cognitive impairment, dementia, or another neurocognitive disorder.

These evaluations are intended to clarify diagnosis and guide medical treatment, safety planning, care needs, or decisions regarding the individual’s level of independence.

Medicare Advantage plans are administered by private insurance companies and are not automatically included. Patients with a Medicare Advantage plan should contact the practice before scheduling so that network participation and coverage can be reviewed.

Cape Cod Psychology does not directly bill commercial insurance plans other than Blue Cross Blue Shield.

Evaluations for patients with other insurance plans are provided on a private-pay basis. Payment is made directly to Cape Cod Psychology according to the selected evaluation package.

Upon request, the practice can provide a detailed receipt or superbill that the patient may submit to an insurance company for possible out-of-network reimbursement. Reimbursement is determined entirely by the patient’s insurance plan and is not guaranteed.

Private-pay evaluations are not restricted by an insurance company’s definition of medical necessity. They may address medical, psychological, developmental, educational, functional, workplace, transition, or other clinically appropriate questions.

The total fee and included services are established before the evaluation begins. A Good Faith Estimate is provided as required.

Cash, checks, Venmo, and credit cards are all acceptable means of payment for all services. 

For further inquiries regarding insurance, please contact Katie at katie@capecodpsychology.com who will work with you to make the most of your benefits.