Neuropsychological Assessments or Tests – 80%

Benefits are provided for neuropsychological assessments or tests required to prescribe an appropriate treatment plan, with an annual maximum of $600 and a lifetime maximum of $1,200. If expenses exceed the $600 annual maximum or $1,200 lifetime maximum, this plan will not pay the additional costs. These services always require 20 percent coinsurance and these coinsurance expenses do not apply toward the $2,300 annual coinsurance maximum. This includes any later reevaluations to make certain the treatment is achieving the desired results. Treatment must be preauthorized with the Trust Office.

Neuropsychological assessments or tests include the administration and interpretation of tests including, but not limited to, the cognitive function of the central nervous system, Minnesota Multiphasic Inventory (MMPI), the Rorschach (inkblot) test, and developmental testing.

Benefits are not provided for:

1. State-required medical assessments for specialized educational programs; services or supplies required by law to be provided by any school system; or treatment for learning disabilities. This exclusion applies regardless of the recommendation of the attending physician.
2. Neurological and psychological testing or evaluations related to rehabilitation, neurodevelopmental therapy, cognitive therapy, dementia, or for a change in the individual’s environment or residence.

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