Does Blue Cross Blue Shield Cover ADHD Testing & Treatment?

Does Blue Cross Blue Shield Cover ADHD Testing & Treatment?

Yes, Blue Cross Blue Shield (BCBS) of Tennessee health insurance may cover ADHD testing & treatment services depending on your insurance plan’s benefits.

Jump to Section

• Does Blue Cross Blue Shield Cover ADHD Testing & Treatment?
• How to Verify Blue Cross Blue Shield ADHD Coverage
• What Is Attention Deficit Hyperactivity Disorder (ADHD)?
• Does Blue Cross Blue Shield Cover ADHD Testing?
• Does Blue Cross Blue Shield Cover ADHD Assessments?
• Does Blue Cross Blue Shield Cover ADHD Treatments & Medications?
• How To Find BCBS ADHD Testing & Treatment Clinics Near Me?
• How Much Does ADHD Testing & Treatment Cost Without Insurance?

How to Verify Blue Cross Blue Shield ADHD Coverage

Athena Care is in-network with most major insurance plans. Find out more about your insurance coverage by calling your insurance company or contacting Athena Care at 877-641-1155.

What Is Attention Deficit Hyperactivity Disorder (ADHD)?

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common pediatric neurodevelopmental disorders. It is most commonly diagnosed in childhood and lasts well into adulthood.

Children with ADHD may struggle to pay attention, manage impulsive behaviors (doing without considering the consequences), or be extremely active.¹

Signs & Symptoms of ADHD

Children who have difficulty focusing and behaving are not uncommon. Still, children with ADHD do not simply grow out of these behaviors.

The following signs of ADHD persist and can be severe, causing problems at school, home, and other social situations.

• Frequent daydreaming
• Forgetfulness
• Difficulty paying attention
• Easily loses things
• Squirming or fidgeting
• Talking too much
• Taking unnecessary risks
• Making careless decisions
• Hard time resisting temptation
• Trouble with taking turns
• Difficulty getting along with others

Does Blue Cross Blue Shield Cover ADHD Testing?

Blue Cross Blue Shield ADHD testing may be covered depending on your specific insurance plan’s benefits.

To diagnose ADHD, doctors use a mix of exams, testing, and other information. The doctor will consult the American Psychiatric Association’s (APA) guidelines, and the following criteria are considered when making the diagnosis:

• An interview with the child.
• Medical background – A doctor will discuss your child’s social, emotional, educational, and behavioral history.
• A physical examination.
• ADHD behavior rating scales² or checklists – Parents and teachers use these to assess the symptoms of their children.

Verbal and written tests may also be used to rule out other health conditions with similar symptoms to ADHD.³

Does Blue Cross Blue Shield Cover ADHD Assessments?

When it comes to the question, “Does Blue Cross Blue Shield cover ADHD assessment?” the answer may vary based on several factors. BCBS mentions that psychological and neuropsychological testing services might be covered if they’re deemed medically necessary. However, routine neuropsychological testing for the diagnosis of ADHD is not considered medically necessary.

The BCBS approach to ADHD aligns with The American Academy of Pediatrics ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment, suggesting a thorough medical record review and proper evaluation in assessing ADHD. As always, it’s crucial to remember that insurance coverage can vary greatly depending on the specifics of each individual’s plan.

Does Blue Cross Blue Shield Cover ADHD Treatments & Medications?

Yes. Blue Cross Blue Shield may cover ADHD treatments and medications. Your plan’s benefits will determine your eligibility and the specifics of your Blue Cross Blue Shield ADHD medication coverage and treatments.

Verify Blue Cross Blue Shield ADHD Coverage Now

Certain medicines are used to manage symptoms of ADHD. The American Academy of Pediatrics (AAP) recommends that children with ADHD be treated with medication and/or behavioral therapy.

Following the administration of medications, patients should be closely monitored, and medicine should be taken consistently. Then, the doctor can check to see if the patient is getting the correct dose. After a few weeks on the medication, the side effects usually fade. Alternatively, the dosage might be reduced to minimize side effects.

Medicines used to treat ADHD include:

• Stimulants⁴
  • Stimulant medications, like Adderall or Ritalin, are commonly used to treat ADHD. These medications work for people of all ages to alleviate symptoms. Behavioral changes are usually rapid and significant.
• Non-Stimulants⁵
  • If stimulant medications cause unpleasant side effects or are ineffective, a doctor may prescribe a non-stimulant medication, like Strattera. These can be taken on their own or in combination with stimulants.
• Complementary or Alternative Medicines⁶
  • Some therapists and other health professionals employ complementary or alternative medicines. These treatments have not proven effective in managing ADHD. However, acupuncture, for example, can assist in relieving stress and muscle tension while also improving your overall health and quality of life.

How To Find BCBS ADHD Testing & Treatment Clinics Near Me?

With Athena Care, gaining access to ADHD testing clinics in Tennessee has never been easier. A care coordinator can assist you with any questions or concerns at one of our various Tennessee locations. Athena Care health clinics are open Monday through Friday, 7:00 a.m. to 6:00 p.m.

When choosing an ADHD testing and treatment care provider, it’s important to keep the following in mind:

• Education, training, license, and years of experience
• Specialties and services offered
• Treatment methods and philosophies
• Insurance companies they work with
• Office hours
• Pricing
• Session length

Also, don’t be afraid to ask questions.

Here, you’ll find a list of practitioners organized by city and information about their backgrounds and specialties.

How Much Does ADHD Testing & Treatment Cost Without Insurance?

The following are average costs for therapy, though they may vary by location and other variables and may not reflect the actual cost of treatment or what you may pay.

Doctor’s visits alone can range from a few hundred dollars to more than $2,700, and the cost of medication can go anywhere from $8 to $288 per month. For example, a month’s supply of widely prescribed generic stimulants costs around $187.97.⁷

In the United States, the typical cost of psychotherapy ranges from $100 to $200⁸ a session, dependent upon the state and the length of the session.

Cognitive Behavioral Therapy (CBT) sessions, for example, can cost between $100 and $200 per session, while Dialectical Behavioral Therapy (DBT) usually consists of a weekly individual therapy session, a weekly group therapy session, and weekly phone conversations. DBT costs vary depending on the type of services rendered.

Telehealth therapy for ADHD patients, especially those in rural communities with limited access to treatment facilities, is also beneficial. More than 66 million people in the United States reside in non-metropolitan counties with a mental health professional shortage, according to the Rural Health Information Hub.⁹ Telehealth sessions for the treatment of ADHD can range from anywhere from a fixed monthly cost to $275 a session.