Autism Screening Cost without Insurance
Early screening and diagnosis of autism are fundamental to providing families with the resources to appropriately help and support their children throughout their development. However, autism screenings and diagnoses can be very costly and time-consuming. Informal screenings can cost anywhere from $0 - $500, while formal diagnostic tests can cost up to $5,000.
Autism Screening Costs
Your out-of-pocket costs for autism screening can differ drastically depending on the method of screening, your insurance coverage, and the facility you are going to. Diagnostic tools tend to be more expensive than general screening checklists and questionnaires.
Autism Spectrum Disorder (ASD) can be screened with five main types of questionnaires and checklists. Screening tools can be given to you by your primary care provider or pediatrician (PCP) free of charge. On many occasions, the only costs of basic developmental screening arise from your doctor visit’s copay. If you are paying with insurance and seeing an in-network provider, your copay will typically be between $15 and $25. If you are paying without insurance, a visit with a primary care provider will likely cost over $100.
Depending on the results of your child’s screening tests, your provider may recommend a formal autism evaluation. Autism can be diagnosed with the help of 4 different diagnostic tools. These tools can be a lot more costly than screening tests. These prices can range from $800 - $5,000, depending on the clinic you visit. Some clinics may accept your health insurance plan, which would pay for part or all of your testing. However, if you go to a clinic that does not take health insurance, you will need to pay the full out-of-pocket costs.
The average cost of an autism screening and full evaluation ranges from around $1,000 - $2,000. A few clinics and their respective autism diagnostic test prices are listed below.
Costs of Full Autism Evaluations in the U.S
|Name of Facility||Location||Price|
|Family Guidance and Therapy Center||Bend, OR||$2,200 for a full evaluation|
|GRASP||New York, NY|
$900 for the most affordable assessment
$1,800 for a full assessment with report
$2,700 for most comprehensive assessment
|Ally Psychological Services||Bucks County, PA||$3,500 for full evaluation|
|Virginia Tech Autism Clinic||Blacksburg, VA||$800 for diagnostic assessment|
|Dr. Macleamy||Petaluma, CA||$2,000 for full assessment|
|Faison Center||Richmond, VA|
$300 for ADOS
$800-1200 for diagnostic evaluation
Autism Screening vs. Autism Diagnosis
There is an important distinction to be made between developmental screening tools and diagnostic tools for autism detection. The prices in the table above account for full diagnostic testing rather than development screening tests.
Your usual PCP or a nurse can perform autism screenings at a check-up appointment. However, screening tools do not provide a formal diagnosis of autism. Instead, they tell your provider that you or your child may need a complete evaluation, which can lead to a formal diagnosis of autism. Typically, screening tests are conducted at a child’s 18 month and 24 month check-up and if a patient shows signs of autism.
The table below outlines the five tools that can be used to screen for autism. These questionnaires and checklists can help indicate whether you or your child needs a full evaluation for autism.
Autism Screening Tools
|Ages and Stages Questionnaire (ASQ)||General screening questionnaire|
|Communication and Symbolic Behavior Scales (CSBS)||Standardized checklist for infants and toddlers|
|Parents’ Evaluation of Developmental Status (PEDS)||Parent interview form|
|Modified Checklist for Autism in Toddlers (M-CHAT)||Checklist used for toddlers between 16 and 30 months of age|
|Screening Tool for Autism in Toddlers and Young Children (STAT)||Interactive screening for children between 24 and 36 months of age. It consists of 12 items and takes 20 minutes to administer.|
Unlike a general screening, a full assessment for autism needs to be conducted by a trained specialist such as a developmental pediatrician or a child psychiatrist. These evaluations tend to be a lot more expensive than basic developmental screenings. However, these diagnostic tests are required if you are applying for social security or disability benefits. For instance, documentation of medical diagnosis and physical proof that your autism has severely affected your ability to work are required for Supplemental Security Income (SSI).
The table below outlines the four tests that can be used to help inform a diagnosis of autism. It is important to speak with your provider about which tests they recommend for you or your child.
Autism Diagnostic Tests
|Autism Diagnosis Interview-Revised (ADI-R)||Clinical diagnostic tool. Used for children and adults over 18 months old.|
|Autism Diagnostic Observation Schedule - Generic (ADOS-G)||Standardized assessment with four, 30-minute modules|
|Gilliam Autism Rating Scale - 2nd Edition (GARS-2)||Helps teachers, parents, and providers diagnose autism in patients aged 3-22.|
|Childhood Autism Rating Scale (CARS)||Brief assessment for children 2 years of age and older.|
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Insurance Coverage for Autism Diagnosis and Support
Receiving a formal autism diagnosis can be very expensive. Nonetheless, there are additional medical costs that you may incur even after you or your child receives an autism diagnosis.
Autism Diagnosis Insurance Coverage
Although all states require coverage for autism treatment, the extent to which screenings and tests are covered will vary drastically from state to state. If you want to see what your state-specific coverage is for autism screenings, click here.
You may be able to get part of an autism screening covered by certain insurance plans as well. For individuals under the age of 21, Medicaid might be able to cover autism screening tests. Based on the Early and Periodic Screening, Diagnostic, and Treatment clause of Medicaid, all necessary tests for children should be covered. Although Medicaid eligibility is often based on income, some states will automatically cover all individuals with disabilities including autism.
If you do not have health insurance and do not qualify for Medicaid, there are a few other ways that you can save money on an autism screening or diagnosis.
- Look for universities or medical centers in your area that may be doing research studies on autism. Some organizations will offer free autism evaluations for individuals who participate in the study.
- If your child is under 3 years old, you can contact the Early Childhood Technical Assistance Center for additional resources.
- If your child is 3 years or older, you can contact your local public school to figure out steps to get your child evaluated.
- If you attend college, check in with your college’s Student Health department to see if they provide autism screenings.
- Speak with the provider administering the autism evaluation. Some offices may offer sliding scale pricing for individuals paying without insurance.
Costs of Autism Support
In addition to screening costs, there may be several other costs that should be taken into consideration after receiving a diagnosis of autism. According to the CDC, the average medical costs for a child with autism in the U.S. can range from $4,110 - $6,200. Depending on the specific case, family members might opt for special earning services, education, and caregivers. For patients that require consistent behavioral interventions and support, medical costs can reach up to $60,000 per year.
Specifically, Applied Behavorial Analysis (ABA) is a very common therapy used to support children with ASD. This type of therapy is used to improve a child’s communication and social behavioral skills. This type of therapy can be intensive and can require a time commitment of 20 to 40 hours a week. Additionally, most ABA therapy needs to be conducted by a board certified ABA therapist that on average, charges a rate of $120/hour.
As of 2022, all states in the U.S have required coverage for autism treatment under state-regulated health insurance plans. Therefore, it is important to speak with your insurance provider about possible services that can be covered for you or your child.
Autism Screening Frequently Asked Questions (FAQs)
Autism diagnosis can be very tricky, as there are currently no definitive medical tests that can tell you if you have autism. The following are answers to some frequently asked questions that can help you or your child’s autism screening go smoothly and effectively.
What occurs during an autism screening?
When being evaluated for autism, a pediatric specialist will most likely give your child a brief test or give you a questionnaire to fill out. The tests will look at various behavioral cues and your child’s developmental history. Specifically, these tools will pick up signs of delayed language skills and cognition, delayed movement skills, unusual mood or eating habits, etc.
The medical team will likely talk to you and your child, asking questions about your day-to-day life to assess communication and relationship skills. In some instances, the examiner may need to come to school or home to properly assess your child's behavior or arrange follow-up assessments. At the end of the screening, you should receive a written summary report which will also be sent to your primary care provider to inform the next steps you should take.
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When should your child get screened for autism?
All children should receive a formal autism screening during their 18-months and 24-month well-child visits. These screenings will generally consist of answering general screening questionnaires or standardized checklists. In some instances, toddlers younger than 18 months can be diagnosed with autism.
Early detection is an incredibly important aspect of autism diagnoses, as it gives the family more time to adjust and obtain the proper tools and resources to help and support their child. Especially in education settings, it is essential that your school staff understands your child’s diagnosis, as it can improve their quality of learning and help manage their mood and behavior.
What are the early signs of autism?
Signs of autism can occur as early as 12 months into a child’s life. It is important to recognize the signs of autism to help your child get a diagnosis as early as possible. Some early signs of autism include
- Atypical social and communicative behavior: avoiding eye contact, does not share interests, does not respond to name by 9 months of age, lack of interest in other children
- Repetitive behaviors and interests: playing with the same toy consistently, has obsessive interests, gets upset easily, repeats words and phrases
While these behaviors do not necessarily indicate that your child has ASD, you should consider bringing your child to an 18-month and 24-month wellness visit for an evaluation.
What is the autism spectrum?
The autism spectrum is a standardized method that categorizes autism spectrum disorder (ASD) into 3 main spectrum levels based on the amount of support required:
- ASD Level 1: Requiring Support
- ASD Level 2: Requiring Substantial Support
- ASD Level 3: Requiring Very Substantial Support
These categorizations can help doctors and other medical staff appropriately choose therapies and behavioral programs to best support you or your child.
Getting an autism screening and evaluation can be extremely time-intensive and expensive. Make sure that you speak with your primary care physician before contacting any 3rd party autism diagnostic clinics. Additionally, if you are insured, make sure to check with your plan to see how much they can cover. If you are uninsured, make sure to check your Medicaid Eligibility.
Mira can assist you in reaching out to a primary care physician for their personalized advice and tips about obtaining an autism diagnosis. For as low as $25 a month, Mira can provide you with affordable in-person and virtual doctors visits, urgent care, and laboratory testing. With Mira, you can always have a central provider to assist you in your needs while looking for autism specialists. Sign up for Mira today.
Sophie is a 2024 Pharm D. candidate studying pharmacy at Rutgers University, New Brunswick. She has a passion for healthcare and writing and hopes to make meaningful contributions to healthcare transparency and accessibility. In her free time, she likes to take care of her houseplants, cook, and hang out with her cat.