How Much Does an Autism Diagnosis Cost in Texas?
According to the CDC, roughly 1 in 36 children in the United States have been diagnosed with autism spectrum disorder (ASD). That number lowers as they become adults, partly due to the challenges of diagnosing the disorder as a person gets older.
As a parent, it is your responsibility to get your child diagnosed as early as possible so you have the tools to ensure they grow up in a safe environment. A child with autism may need a lot more support than many of their peers. The only problem is affording evaluation and assessment services.
So, how much does an autism diagnosis cost in Texas?
Diagnosing Autism Spectrum Disorder
An ASD diagnosis can be acquired as early as 18 months of age. After they reach 2 years, you can get a much more reliable diagnosis.
The overall process can take anywhere from a few months to over a year depending on specialist availability. It requires multiple visits, potentially with different physicians and mental health specialists. However, it’s best to get this done in their early years.
One of the reasons it’s important to figure out your child’s learning disorder is that many of the ASD symptoms overlap with other disorders.
For example, both ASD and sensory processing disorder will lead to a toddler screaming in reaction to loud noises. They may also want to physically interact with everything in a room.
Knowing their learning disorders will also make it easier for their educational facility to create plans and accommodations for them.
How Much Does an Autism Diagnosis Cost?
The cost of a diagnosis will vary based on the process you and your child go through.
Some providers will charge separately for each part of the process. You may also need to visit multiple different specialists and doctors for each part of the assessment.
In other cases, a provider could offer a package deal to cover the entire diagnostic process. This often involves some kind of discount as well as only needing to meet with one or two specialists in total.
Additionally, it may be more expensive to pursue a diagnosis in person as opposed to through telemedicine. You’ll also find it easier to schedule a virtual consultation.
Expect to pay at least $1,000 for autism screening.
Insurance Coverage
Your family’s insurance plan and the type of evaluation will determine how much coverage you can expect for your child. However, the Affordable Care Act requires all plans to provide some kind of coverage for mental health care.
In addition, the state of Texas has a specific autism mandate. It states that an enrollee must have coverage for their autism spectrum disorder from their diagnosis date up until they are nine years of age.
What this means for parents is that it’s much easier and more affordable to get your child diagnosed with ASD when they’re under the age of nine as opposed to when they become a preteen or teenager. You can expect at least partial coverage if not total coverage of the costs.
The Diagnosis Process for Children
There are four main steps in diagnosing children under the age of 5. These steps include:
- Review the M-CHAT-R
- Performs a standardized interview
- Review a video of their home interactions
- Present the diagnostic
These will all happen at different appointments, either in the office or by teleconference. You may get billed separately for each step, depending on your arrangement with the physician.
1. M-CHAT-R
First, parents will have to complete the M-CHAT-R with their child. The M-CHAT-R, or Modified Checklist for Autism in Toddlers, Revised, is administered by a pediatrician or primary care provider. It’s usually done as part of a regular check-up as part of their visit.
If a child is suspected to have autism, then their parents will take this test. It involves 20 questions and functions as a sort of checklist. The results will show if their child is at risk for autism.
There is no extra associated cost other than your standard visit copay.
2. Standardized Interview
With the M-CHAT-R in hand, the parent can now schedule a consultation with a psychologist or some other specialist in autism. They will discuss a variety of factors such as the child’s birth history, developmental history, and behaviors at home.
This interview may be performed through telemedicine, depending on what office they use.
Some specialists will use the Vineland Adaptive Behavior Scales to measure adaptive behavior and support their diagnosis. The areas of assessment include communication, activities of daily living, social relationships, and developmental status.
3. Review of Video Sent In
For the third step, parents will need to send in a video of them interacting with their child. They will follow a protocol sent to them based on the Autism Diagnostic Observation Scale 2 (ADOS-2). This allows the specialist to accurately assess and diagnose the disorder across age and developmental levels.
Some of the signs of autism in toddlers include not showing facial expressions by 9 months of age, using few gestures by 12 months, and not sharing interests with others by 15 months of age. They may have obsessive interests and play with toys the same way every time.
4. Final Appointment
The final appointment is where your doctor will present the test results. This will include the official diagnosis, a prescription for future services, and a discussion of what the parents can do at home.
They will also let you know if any further testing is required for something like their hearing or neurological symptoms. These are often supplementary and not included in the cost of the initial diagnosis.
Learn More About Autism Spectrum Disorder
How much does an autism diagnosis cost in your area? It may be as little as a few hundred dollars or go up to a couple thousand depending on a variety of different factors. However, your family’s insurance should cover most, if not all of the cost for your child.
Developmental Pediatrics has been serving Texas for over 20 years. We offer both Telehealth and in-person ASD testing using the Autism Diagnostics Observation Scales 2. Contact us today to learn more and schedule your child’s assessment visit with our team.
