Evaluations

Overview

Comprehensive Diagnostic evaluations (also known as comprehensive developmental or psychological evaluations) are conducted by licensed clinical psychologists specializing in autism spectrum disorders.

Evaluation FAQs

1. What does a comprehensive diagnostic evaluation include?

   At ADI, our psychologists provide autism-focused comprehensive diagnostic evaluations. The purpose of these evaluations is to determine whether your child meets formal criteria for an autism spectrum disorder or another related neurodevelopmental condition. Evaluations include an interview with the parent/caregiver, cognitive assessment, and a standardized observational assessment. Additional assessments may be included depending on your goals for the evaluation.

2. Who conducts the comprehensive diagnostic evaluation?

   Our evaluations are conducted by licensed, doctoral-level clinical psychologists. Evaluations may also be conducted by a post-doctoral psychological associate supervised by one of our clinical psychologists.

3. How do I obtain the results of a comprehensive diagnostic evaluation?

   The results of each evaluation are shared during a feedback session with the psychologist. This session is usually scheduled approximately two weeks after the scheduled evaluation, but your psychologist may provide informal impressions on the same day as the evaluation. All evaluations are summarized in a comprehensive written report. Families can request a written summary of the evaluation results by requesting them through MyChart or contacting Medical Records.

4. Will my insurance cover the comprehensive diagnostic evaluation?

   Comprehensive diagnostic evaluations may be covered through your individual health plan. Evaluations are typically billed through mental health benefits, under CPT codes for Psychological Testing (96130/96131) and Psychological Evaluation Services (96136/96137). ADI is currently in-network with Aetna, United Health Care/Optum, and Tricare for diagnostic evaluations. Coverage varies across individual plans and is not guaranteed. Out-of-network coverage may be available depending on individual benefits. Please note that ADI is not in-network with Medi-Cal. For families without insurance or out-of-network coverage, self-pay options are available. Please contact our team at 858-966-7453 (Option 2) if you have questions about your health plan coverage or self-pay”

5. How do I schedule a comprehensive diagnostic evaluation at ADI for my child?

   In October 2023, ADI established new guidelines to help us focus on providing comprehensive diagnostic evaluations for children who are in the most critical need of assessment. Under these guidelines, all families are required to complete a phone screening with a member of our care coordination team to determine if their child is eligible for evaluation at ADI. The entire scheduling process is as follows:

   i. ADI receives a referral for psychological evaluation services/psychological testing by your child’s primary care physician.

   ii. A member of the ADI Care Coordination Team contacts your family to complete a phone screening to determine eligibility for evaluation.

   iii. Children who are eligible for evaluation are placed on a waitlist and scheduled for evaluation in the order in which their referral was received.

6. How long is your wait list for comprehensive diagnostic evaluations?

   In 2023, wait times for children from 12 months-5 years were approximately 6 – 9 months and wait times for children 6 years and older were approximately 12-18 months. In October 2023, ADI established new scheduling guidelines in an effort to reduce wait times for children in the most critical need of assessment. Children identified through clinical intake in critical need for evaluation are offered expedited evaluations. All children waiting for an evaluation at ADI may qualify for care coordination support.

7. If my child has already received a diagnosis of autism spectrum disorder, can they be seen at ADI for a re-evaluation?

   Our clinic prioritizes families who have not yet had the chance to be evaluated by a psychologist and as a result cannot access services. For that reason, we currently do not provide re-evaluations for children who have previously received an autism diagnosis. Our Care Coordination team is available to provide alternative clinics and/or clinical providers who may be available for re-evaluations. We also offer a range of treatment services for children with an existing diagnosis.