Yeah, yeah, don't need a full assessment to dx ADHD depending on who you talk to. But what is the feasibility of have an ADHD-only assessment practice? Too specialized? Also what is the reimbursement rate for ADHD evals from insurance?
Yeah, yeah, don't need a full assessment to dx ADHD depending on who you talk to. But what is the feasibility of have an ADHD-only assessment practice? Too specialized? Also what is the reimbursement rate for ADHD evals from insurance?
The thing is, at least in my area, plenty of people pay for this testing but theur actual symptoms and timeline of impairment don't line up with an ADHD diagnosis. You can probably make a good amount of money doing it, and there are lazier clinicians that will refer primarily to these tests in adult patients. But they're no substitute for a thorough psychiatric evaluation, just one extra thing to considerYeah, yeah, don't need a full assessment to dx ADHD depending on who you talk to. But what is the feasibility of have an ADHD-only assessment practice? Too specialized? Also what is the reimbursement rate for ADHD evals from insurance?
You can probably make a good amount of money doing it,
Around here they charge $350, cash. Seems like a scam tbph, basically just an assessment and TOVA test, but a lot of people pay because it's usually enough to get Adderall from a PCPNo. Probably not. ADHD is everywhere. But, coincidentally, the diagnosis is most prominent in younger Medicaid populations. Go figure? Take that for what it's worth.
Unless its waaaay complicated by other possible things.... usually its a 90791/90792, rating scales and we're done. Is that bad? Or maybe we just don't like misbehaved kids with crappy parents from disadvantaged backgrounds/circumstances?
Around here they charge $350, cash. Seems like a scam tbph, basically just an assessment and TOVA test, but a lot of people pay because it's usually enough to get Adderall from a PCP
No. Probably not. ADHD is everywhere. But, coincidentally, the diagnosis is most prominent in younger Medicaid populations. Go figure? Take that for what it's worth.
Yes, I certainly see the ethical dilemma to this. It’s incredible how So many people want this diagnosis now.20 years ago, you'd be full of honest patients. Nowadays, you'd basically be putting up a neon sign that reads, "legalized meth doled out here.". Which means you'd be full until word got out that you're not just handing out diagnoses. If you acted unethically, you'd find your office full of increasingly shady groups of drugged out people until you get shut down. If you acted ethically, that same group would spread the word that you don’t play ball and you’d lose the volume to the unethical people who also got the upper middle class.
@erg923 might have other citations but here is an CMS OIG report:If you have a citation for this I would really like it for something I'm involved in. Feel welcome to post here or PM.
@erg923 might have other citations but here is an CMS OIG report:
Depends on the diagnosis 😉Should you? No. Should you build a practice around one diagnosis? No!
Yes, I certainly see the ethical dilemma to this. It’s incredible how So many people want this diagnosis now.
That sounds like a terrible idea for so many reasons. What you could probably do though is therapy to focus on behavioral / skills-based strategies to improve related difficulties / executive functioning. SO many people pay out of pocket for pseudo-treatments- I would hope that with the right advertising/promotion those folks would be willing to go for something backed up by research that insurance would also pay for. It's hard in my area to find therapists who do that well even though that's what I recommend very strongly to all of my clients who get an ADHD dx.
I used to be about the only guy in town who would do adult ADHD assessments. I had a detailed informed-consent emphasizing the nonspecific nature of most adult ADHD symptoms, and mentioning that a majority of adults who think they have ADHD usually do not. I then used a therapeutic assessment approach in terms of the assessment feedback. All this and a good dose of empathy (which is always a good idea, of course), meant I had very few complaints and the psychiatrists and neurologists who referred to me were happy, as were most of the patients.
I stopped filing insurance for patients and belonging to insurance panels in 1997, so getting approval from a mangled care company was not an issue.
Pediatric ADHD assessment is a different enterprise, as you know. I'm no expert there, but I would suggest the Testing Psychologist podcasts, which are excellent in general, and often cover ADHD topics, and the Testing Psychologist group on Facebook. A ton of very knowledgeable child & adolescent and school psychologists hang out there, plus a few adult psychologists like me, soaking up the wisdom. 🙂
This was in latter half of the 1990s until 2007, so I would adjust based on research if I were doing adult ADHD assessments now. I'm also pulling this quickly from memory. With those provisos ....As someone who routinely does adult ADHD testing, can I ask what your assessment procedure was?
It's really more about marketing IMHO. If someone like you has an established, successful assessment practice, then you probably don't need to do any niche marketing because you already have steady referral sources (because you do excellent work, I would bet). But for someone in the earlier stages of building an independent practice, marketing is important.I'm a little confused as to how you would build an entire practice around just one diagnosis... if the clients coming in already know their diagnosis, why would they need you? If they only suspect ADHD, then in reality you're going to end up doing a lot of different types of evals, because a lot of people who think they have it actually don't. Am I missing something? I guess you could just do a whole report that says: We checked for ADHD and you don't have it. That seems weird. In my side-hustle private practice, I do a variety of evals, a lot of which are for suspected ADHD - but I would never refer to these as "ADHD evaluations." They're psychodiagnostic evaluations - based on the interview and early testing results, it could - and often does - go in another direction entirely. FWIW I don't take insurance, and have found if you are open and transparent about the hypothesis testing assessment process with clients, they don't complain.