Cost of Testing, Therapy, Tutoring ?

[HeidiD]

Hi All,

 

I'm wondering how much I might expect to pay for the following:

 

- CAPD testing

 

- Dysgraphia testing to document for SATs

 

- speech therapy for stuttering, cluttering and articulation of "r" sounds, mainly - what is the cost per hour?

 

Also, a question for those of you who tutor special needs kids - what do you charge per hour?

[LizzyBee]

Two of our kids have been tested for APD, and we only had to pay our insurance co-pay. I think the charge before the insurance reduction was about $700. However, we went to an audiologist who works out of an ENT office. If we had gone to Duke (where many people around here go for APD testing), it would have cost much, much more. Same two kids were evaluated by an OT for a variety of things, and again we only had to pay our co-pay, but I think the total charge was about $225. One of them has OT weekly, including handwriting instruction and practice, and insurance covers it. I think the bill is about $75/week, but we only pay a co-pay. One of our kids had speech therapy for 3 years, and I think the weekly charge was $65, but again, our insurance covered all of it except the co-pays.

[Dobela]

It really depends on your area and your insurance. For my son an OT eval was $300 and each visit was $88/hr. Our insurance didn't cover any of this so we paid out of pocket. However, because our insurance didn't pay, he then qualified for the state insurance like Medicaid. The state insurance now pays for all therapies and related services while we pay a small montly fee based on our income. We applied as soon as he qualified and the paperwork took 1 year to move thru the system.

 

If you want to know costs, just start calling centers and private providers. They can tell you how much they charge and then when you call your insurance, they can tellyou how much of that you will be responsible for.

[HeidiD]

It really depends on your area and your insurance. For my son an OT eval was $300 and each visit was $88/hr. Our insurance didn't cover any of this so we paid out of pocket.

 

Unfortunately my insurance won't cover this either. Did you find that the cost for the therapy was worth it? How long was it required? Two of my kids are dysgraphic and therapy for both would really add up quickly.

[HeidiD]

Two of our kids have been tested for APD, and we only had to pay our insurance co-pay. I think the charge before the insurance reduction was about $700. However, we went to an audiologist who works out of an ENT office. If we had gone to Duke (where many people around here go for APD testing), it would have cost much, much more. Same two kids were evaluated by an OT for a variety of things, and again we only had to pay our co-pay, but I think the total charge was about $225. One of them has OT weekly, including handwriting instruction and practice, and insurance covers it. I think the bill is about $75/week, but we only pay a co-pay. One of our kids had speech therapy for 3 years, and I think the weekly charge was $65, but again, our insurance covered all of it except the co-pays.

 

Wow, you have generous insurance. Our military insurance is very limited in its coverage of speech therapy, etc., and no education-related therapies seem to be covered.

 

Could you tell me what the APD testing entailed? Tomorrow is our first appointment, going through an ear specialist for an initial screening. What other types of assessments are required to make a diagnosis?

[LizzyBee]

Wow, you have generous insurance. Our military insurance is very limited in its coverage of speech therapy, etc., and no education-related therapies seem to be covered.

 

Could you tell me what the APD testing entailed? Tomorrow is our first appointment, going through an ear specialist for an initial screening. What other types of assessments are required to make a diagnosis?

 

We have BC/BS. We've had it in 2 states, and it is great. We've never had to appeal to get anything covered. I have no idea why so many insurance companies won't cover APD testing, since it's a neurological disorder, not an educational issue. Of course, it affects education, but that doesn't make it a non-medical issue.

 

The APD testing took a couple of hours, but I can't remember what all they did. They did some hearing tests that are more sensitive than regular hearing tests, and they check for auditory discrimination and phonemic awareness, among other things. The audiologist gave us lots of ideas to use in both group settings and homeschooling.

[kiki]

We pay our co-pay for each visit. Our insurance generally doesn't cover Speech and Language but our therapists had the pediatrician's office count the number of ear infections each of the kids had from the first infection to the last infection and amazingly they covered it. Insurance covered about 70% of APD testing. Ask your provider for the insruance codes that they think would be applicable and then call your insurance, this is what we did for APD testing.

 

Good Luck,

Kirstin

[LizzyBee]

We pay our co-pay for each visit. Our insurance generally doesn't cover Speech and Language but our therapists had the pediatrician's office count the number of ear infections each of the kids had from the first infection to the last infection and amazingly they covered it. Insurance covered about 70% of APD testing. Ask your provider for the insruance codes that they think would be applicable and then call your insurance, this is what we did for APD testing.

 

Good Luck,

Kirstin

 

That's a good point - both of our kids had a hx of ear infections, though not an excessive number. But that was probably a point in our favor for getting tests and therapy covered. One of them had complained of ringing in her ears before we went to see an ENT dr then the audiologist. Apparently she'd had it for years and didn't mention it because she didn't know it wasn't normal.

[Misty]

We have always had good coverage with the military insurance (Tricare).. My daughter has Asperger's and she goes to OT once a week for fine motor deficits and sensory issues. Tricare pays every penny. We have never had to pay out of pocket for anything, including all the testing that we have gone through with psychologists, etc. All of my children have been through testing, leading to their diagnoses, and we have never paid anything. Are you Tricare Prime or Standard?

 

Having a solid diagnosis of something will help you to navigate Tricare better. Since we have Asperger's down as our daughter's main diagnosis, things are easier for us. But I still don't think you should be having these issues. Are you on the homeschoolmilitary yahoo group? I would join there and ask questions. Some of the moms there are dealing with these types of issues. They are very knowledgable.

 

http://groups.yahoo.com/group/HomeschoolMilitary/

[Dobela]

Unfortunately my insurance won't cover this either. Did you find that the cost for the therapy was worth it? How long was it required? Two of my kids are dysgraphic and therapy for both would really add up quickly.

 

We have BC/BS insurance but our type policy didn't cover any therapy. They said they would, but then said our policy had a $5000 deductible for any therapy.

 

Yes, I absolutely found the price of therapy worth it. Before we began OT my son was almost 8 and still could not remember how to write 80% of his numbers and letters. The other 20% were error filled. I was already using HWT and not making progress. His OT continued with HWT but added in sensory activities that helped him learn things such as body in space, body sequencing, and fine motor strength. The first year he qualified for 1 hour per week and was found to be functioning 4 years behind his age. When he tested for this year, he only qualified for 30 minutes weekly, and just barely that, and was just 1 year delayed. We fully expect him to no longer qualify after this year. I could have done some at home, but he loved having a new *teacher* and since most of her activities were presented as games he had a blast. I doubt I could have made it as fun or as effective. She often sent him home with homework that we could do together as well. It was nice being able to work together.

 

When it was confirmed that our insurance did not pay for therapy, our OT suggested we apply for medicaid. Her testing identified a disability and without therapy he would not be able to compete age appropriate activities. It took 1 year for medicaid to be approved (nice efficient system :tongue_smilie:) and then Medicaid paid for everything. They even went back and paid for therapies we had paid for already meaning the OT was able to give us a nice reimbursement. The type medicaid he qualified for only pays after our insurance. Then it pays whatever our insurance doesn't. I don't think we could do therapy as often without it. I actually took in babysitting a few hours a week to pay for the therapy the first year. And I would do it again.

[HeidiD]

the pediatrician's office count the number of ear infections each of the kids had from the first infection to the last infection and amazingly they covered it.

 

Thank you. I think this will help. He had a double ear infection at 3 mo followed by a number of other infections until he was 4 or 5. Clearly a medical issue.

[HeidiD]

We have always had good coverage with the military insurance (Tricare).. My daughter has Asperger's and she goes to OT once a week for fine motor deficits and sensory issues. Tricare pays every penny. We have never had to pay out of pocket for anything, including all the testing that we have gone through with psychologists, etc. All of my children have been through testing, leading to their diagnoses, and we have never paid anything. Are you Tricare Prime or Standard?

 

 

 

Tricare Standard. We also have a child with Aspergers, and her treatment is covered. ASD seems to be in a special category with regard to Tricare. They also would cover a speech evaluation at Childrens Hospital if it is part of a battery of tests including medical ones, but not the therapy (unless the underlying cause is autism spectrum disorder, disease, injury or hearing loss. We'll find out today if there is any hearing loss (I doubt it, but I may be wrong). If so, they'll cover speech therapy.

[HeidiD]

he loved having a new *teacher* and since most of her activities were presented as games he had a blast.

 

That's wonderful. Having an outside "teacher" can really improve motivation. And in the case of those of us whose dealing with kids with multiple issues, a much-needed rest. :)