Insurance Info

New Exciting Progress on the Insurance Front:

Beginning in 2012, ISNR became involved in discussions with United Health Care on insurance reimbursement for neurofeedback. In a related effort, the ISNR Board of Directors commissioned Ed Pigott, PhD to author a white paper on a comprehensive meta-analysis comparing the effectiveness of neurofeedback to behavior therapy, cognitive behavior therapy, and stimulant medication for treatment of ADHD.

This white paper was created to fulfill several needs, the first being for a thorough documentation of neurofeedback efficacy that was presented to United Health Care during the insurance reimbursement meetings. Another need was for a comprehensive document that neurofeedback practitioners could access for insurance appeals and insurance parity requests on behalf of their clients. This paper also provides a current reference list of neurofeedback studies for ADHD, and addresses issues related to appropriate research designs for learning-based treatments such as neurofeedback.

For access to the site, white paper, and Insurance letter kit click: ISNR White Paper Insurance Reimbursement . You may print and send to your provider encouraging coverage for neurofeedback or to assist in reimbursement for already paid services.

At Dallas Brain Changers, we are not on insurance panels, and we do not file insurance paperwork for you. We supply receipts and documentation that will assist you with filing with your insurance provider. This paper work lists the appropriate CPT codes for your sessions. You simply mail it in.

Compare Dallas Brain Changers to Insurance Providers

Click on Charts to Enlarge

Session Equivalent – Dallas Brain Changers vs Insurance Provider
Months required to complete 20 sessions
Client Out of Pocket Expense for Neurofeedback
  1. Get twice the treatment with each session
  2. Get results up to 5 times faster !!!
  3. Out of pocket expense is only $22 more per session than a typical co-pay insurance plan

Clients pay Dallas Brain Changers with credit card or check. Sessions are recorded as EEG Biofeedback (Neurofeedback) insurance code 90901. Sometimes insurance companies cover the codes and reimburse. However, with the ever-changing Insurance industry, insurance companies have become very good at denying reimbursement. This is not unique to neurofeedback. We have been informed by some clients that by getting your family practitioner, MD, or psychiatrist to prescribe eeg-biofeedback (same as neurofeedback) or biofeedback and refer to Dallas Brain Changers, that this may increase the odds of reimbursement.

It has been reported that insurance companies will assure clients they will cover treatment, and then, they subsequently deny claims. Additionally, it has been reported that most insurance companies are good at saying no, at least in the first submittal, and those clients who are aggressive at appealing may increase the chances of reimbursement. Insurance policies vary from company to company, and this includes which diagnosis codes they will reimburse. It has been rumored that some individuals have attempted to contest claims by stating that the insurance companies are forcing the use of medications with significant side effects while denying research-based treatments (such as neurofeedback) that have no side effects. We do not know how successful this argument has been for clients.

 90901 Biofeedback by any modality, including Neurofeedback
 90876 Individual Counseling with biofeedback, any modality
 90801 Diagnostic Interview/Initial Evaluation
 96115 ADD (AD/HD) assessment by computer  *96116
 95830 Digital EEG recording
 95957 Digital EEG analysis
 99090 Reference EEG database

 *Secondary Code may be used

 

Apply your Flex Spending Account (FSA) to this Innovative, Effective Treatment!