Common Insurance Billing Codes for Autism Evaluations

To help you understand if your insurance plan will reimburse the full AAEC evaluation at the Western Evaluation Center for Autism and Neurodevelopmental Disorders at WMU, we have created a list of commonly used codes by providers. Please note that other codes may be used at the providers' discretion related to the services provided. This is not an exhaustive list.

Codes that are recognized or payable by your insurance does not guarantee the full payment. You are responsible for costs incurred that your insurance company does not cover. In the unlikely event of an overpayment, a refund will be issued to you.

Your medical insurance deductible will apply to all your charges received at the UC/WECAN. The deductible works similar to how your car insurance works - if you get an auto accident,  you must first pay your deductible before the insurance company will pay to get your car fixed.

Please ensure that you contact your insurance company for any additional questions you may have regarding your insurance coverage.

Speech/Language Pathologist

92523 Evaluation of speech sound production with evaluation of
language comprehension and expression
96111 Developmental testing, interpretation and reporting

 

 

 

Licensed Psychologist

90791 Psychiatric diagnostic evaluation without medical services
90846 Family psychotherapy without the patient present
90847 Family psychotherapy with the patient present
96101 Psychological testing, interpretation and reporting

 

 

 

 

 
Developmental Pediatrician

90887 Interpretation of results - Psychiatric with advice to family
92551 Pure tone hearing screening
99203 New patient visit, level III (30 min)
99204 New patient visit, level IV (45 min)
99205 New patient, level V (60 minutes, diagnostic)
99213 Established patient visit, level III (15 min)
99214 Established patient visit, level IV (25 min)
99215 Established patient visit, level V (40 min)
99367 Team conference with MD, without patient/family (30 min)