Health Insurance

We are not opening new MassHealth cases at this time. Feel free to check back with our practice in a few months for an update on this. We do not take any private insuranace.

Q. What if I am currently waitlisted for an evaluation?

A. We hope to see everyone on our waitlist who still wants to be seen. Please respond to us promptly when we contact you to open your case, so we  can attend to everyone as promptly as possible.

Q. Will my insurance reimburse me if I pay you out of pocket?

A. If you have private insurance, you can only receive reimbursement if you have a PPO plan, and different plans have different policies. We cannot guarantee you will receive reimbursement or how much, but we are happy to provide you with a superbill you can submit to your insurance.

If you have an HMO plan with a private insurer, you will not receive reimbursment from the insurer.

If you have MassHealth, you cannot pay privately for an evaluation, as it violates our agreement with the insurer.  This is true even if you have MassHealth only as your secondary insurance (i.e. you have private insurance or Medicare that pays most of your healthcare costs and MassHealth only picks up your copays).

Q. I have a PPO health insurance plan with an insurance you do not take, can I have the plan pay you directly?

A. We do not accept direct payment from any insurers for whom we are not in network. You would be responsible for payment to us but we can provide you with an invoice to submit to your insurance company. You may be able to get some of the cost of the evaluation reimbursed by your PPO plan after the fact but you should call them before we get started to doublecheck.

Q. Do you offer any payment plans/financing?

A. For self-pay, we break up the cost of intake and evaluation into three parts. We require payment for the initial consultation prior to the consultation appointment. If you proceed with testing, we require 50 percent of the total evaluation cost before the first testing session. We require the remaining 50 percent to be paid prior to our starting to write your test report. For those who need financing, we offer several options through CareCredit. You can discuss these with us or find more information here: https://www.carecredit.com/go/625BPP/

If you are paying privately for testing, we work on a flat rate model with a variety of components based on your clinical needs, the purpose of the evaluation, and your preferences.

Generally speaking, for all evaluations we offer testing plus a full report. The report includes an appendix containing all your scores and you also receive 1-2 sessions in which we go over the results and recommendations with you.

We would discuss with you at the conclusion of the initial consultation session what type(s) of testing we would recommend based on your situation and needs. We have found that for self-pay, the flat rate model works the best, as there are no surprises for you as to cost as we go along. We ask for half the testing fee at the first testing appointment and the balance before we write the report. We take cash, checks, and credit cards.

The initial consultation is $350. 

Testing (neuropsychological, psychological, and/or academic) is billed at a flat-rate of $4000. This rate includes any and all testing we deem clinically appropriate and relevant to the referral questions, any appropriate collateral contacts, a thoughtfully written report that includes scores and recommendations, and one to two feedback sessions to go over the results with you and/or your child if it is a child case. We charge our hourly rate ($250) for other services that are not part of an evaluation, if you request them, such as attending school meetings and writing support letters.

Fees for legal cases are higher, and we typically work using a retainer structure. We are happy to discuss these rates with you if your case is legal, rather than clinical.

Dr. Rutherford is also licensed in New York State and can provide services there via telehealth. These services are priced higher due to the additional work required to offer this option and keep abreast of NY practice and policies, but are reasonable by NY standards. If you are a potential client in New York State, rates will be discussed with you before any services are undertake

You have the right to receive a “Good Faith Estimate” explaining how much your healthcare services will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance (i.e., paying out of pocket) an estimate of the bill for healthcare items and services.  

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare items or services. 

Make sure your healthcare provider gives you a Good Faith Estimate in writing at least 1 business day before your healthcare service occurs. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service. 

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. 

Make sure to save a copy or picture of your Good Faith Estimate. 

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises