ADHD Diagnosis & Therapy Costs in New York

Overview

New York State is home to nearly 20 million residents and presents one of the most varied cost landscapes for mental health care in the country. New York City commands some of the highest therapy and evaluation rates nationally, while upstate regions -- Buffalo, Rochester, Syracuse, and Albany -- offer significantly lower costs. New York has among the strongest mental health parity laws in the nation, and its Medicaid program is one of the most generous, with no copays for behavioral health services.

For adults in New York seeking an ADHD evaluation, the state offers a wide spectrum of options ranging from premier academic medical centers in Manhattan to community-based clinics serving every county. Understanding this range is essential to finding the right fit for your needs and budget.

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Adult ADHD Diagnosis Costs

Private Evaluation

A comprehensive private ADHD evaluation in New York typically costs $2,000, with a range of $500 to $3,500. Manhattan and Brooklyn clinics routinely charge $2,000 or more for full neuropsychological batteries, while upstate providers in Buffalo, Rochester, and Albany often charge $800 to $1,500.

Public / Insurance-Based Evaluation

Through New York Medicaid, NYC Health + Hospitals, and community mental health centers, ADHD evaluations are available at $0 to $100. New York Medicaid charges no copays for behavioral health services, making it one of the most accessible public systems in the country.

Private vs. Public: Side-by-Side Comparison

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Major ADHD Clinics and Providers in New York

New York City (Manhattan / Brooklyn)

Westchester / Long Island

Buffalo / Rochester / Upstate

Albany / Capital Region

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Therapy Rates

Licensed Clinical Social Workers (LCSW)

LCSW practitioners in New York charge an average of $190 per hour, with rates ranging from $150 to $250. Manhattan and Brooklyn rates are at the high end, while upstate regions are closer to the national average.

Psychologists (PhD / PsyD)

Licensed psychologists in New York charge an average of $280 per hour, with rates ranging from $200 to $400. New York City psychologists specializing in adult ADHD and neuropsychological testing command the highest fees.

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Insurance Landscape

New York has a favorable insurance environment for ADHD treatment, with an insurance friendliness score of 8 out of 10. The state's Timothy's Law (Mental Health Parity Law) requires comprehensive mental health coverage from all insurers. New York Medicaid is one of the most generous in the nation, with no copays for behavioral health services and broad managed care networks.

Empire BCBS, UnitedHealthcare/Oxford, and Aetna maintain large provider networks across the state. The state's Essential Plan also provides low-cost coverage for individuals who earn too much for Medicaid but cannot afford marketplace plans.

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Tips for Low-Income Residents

1. Enroll in New York Medicaid

New York offers Medicaid to adults earning up to 138% of the federal poverty level, with $0 copays for all behavioral health services including ADHD evaluation, therapy, and medication. Apply through NY State of Health (nystateofhealth.ny.gov).

2. Explore the Essential Plan

For individuals earning 138-200% of the FPL, New York's Essential Plan offers coverage for as low as $0-$20/month with low copays for mental health services.

3. Access NYC Health + Hospitals

If you are in New York City, the public hospital system (NYC H+H) provides psychiatric evaluations regardless of insurance status or ability to pay. Fees are based on a sliding scale.

4. Use University Training Clinics

New York universities offer reduced-rate evaluations ($150 - $600):

• Columbia University Psychological Center (NYC)
• NYU Psychology Clinic (NYC)
• UB Psychological Services Center (Buffalo)
• SUNY Albany Psychological Services Center (Albany)

5. Contact Community Mental Health Centers

Each county in New York operates community mental health services. The NYS Office of Mental Health maintains a provider directory at omh.ny.gov. Call 1-800-597-8481 (NYS OMH helpline) or 2-1-1 for referrals.

6. Utilize NAMI New York State

NAMI NYS offers free support groups, educational programs, and assistance navigating the mental health system across the state.

7. Prescription Assistance

• NY Medicaid covers ADHD medications at $0 copay.
• Generic stimulants are available for $15-$40/month at discount pharmacies.
• EPIC (Elderly Pharmaceutical Insurance Coverage) assists seniors with medication costs.

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Financial Assistance & Cost-Saving Tips

Despite New York's high costs -- particularly in the city -- the state offers some of the strongest financial safety nets for mental health care in the country.

1. University Psychology Training Clinics

New York's universities offer high-quality, reduced-rate ADHD evaluations ($150-$600) supervised by licensed faculty.

• Columbia University Psychological Center -- $200-$600 (NYC)
• NYU Psychology Clinic -- $150-$500 (NYC)
• UB Psychological Services Center -- $100-$400 (Buffalo)
• SUNY Albany Psychological Services Center -- $100-$350 (Albany)

2. NYC Health + Hospitals (NYC Residents)

New York City's public hospital system provides psychiatric evaluations regardless of insurance status, immigration status, or ability to pay. Fees are based on a sliding scale. Locations include Bellevue, Elmhurst, Kings County, and Lincoln hospitals.

3. The Essential Plan

For New Yorkers earning 138-200% of the FPL who earn too much for Medicaid, the Essential Plan provides health coverage for $0-$20/month with low copays for mental health services -- including ADHD evaluation and therapy.

4. Out-of-Network Reimbursement

Many NYC therapists and psychologists are out of network. If you have a PPO plan, request a superbill and submit it for reimbursement. New York's surprise billing protections (under the No Surprises Act and state law) also apply to certain behavioral health scenarios.

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Insurance Coverage Overview

New York has one of the most favorable insurance environments in the country for ADHD treatment, anchored by strong parity laws and a generous Medicaid program.

Empire Blue Cross Blue Shield is the largest commercial insurer in New York. It covers ADHD evaluation and therapy with copays of $25 to $75 per session. Neuropsychological testing requires prior authorization and a referral. Empire maintains a searchable provider directory that can be filtered by behavioral health specialty.

UnitedHealthcare / Oxford plans are widely used in the NYC metro area. Oxford plans typically do not require prior authorization for initial psychiatric evaluations. Copays range from $25 to $65 per session.

New York Medicaid is among the most comprehensive in the nation, with $0 copays for all behavioral health services -- including ADHD evaluation, therapy, and medication. Managed care plans (such as Healthfirst, Fidelis, and MetroPlus) coordinate care. There is no prior authorization required for behavioral health visits under most NY Medicaid managed care plans.

Key tips:

• Timothy's Law (NY Mental Health Parity Law) requires all insurers in New York to provide comprehensive mental health coverage at parity with medical benefits. If an ADHD claim is denied, cite this law in your appeal.
• New York's out-of-network consumer protections are among the strongest in the country. If you are charged more than your in-network copay for an inadvertent out-of-network visit, file a complaint with the NYS Department of Financial Services.

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Diagnostic Process Guide

Step 1: Contact Your PCP or Self-Refer. In New York, many insurance plans allow self-referral to behavioral health providers. Check with your insurer. Alternatively, start with your PCP for an initial screening -- most NY PCPs can diagnose uncomplicated adult ADHD.

Step 2: Choose a Provider. Options include in-network psychiatrists, psychologists through your insurance, NYC Health + Hospitals (for NYC residents), or a university training clinic. For Medicaid recipients, call your managed care plan for a list of behavioral health providers.

Step 3: Verify Benefits. Call your insurer to confirm in-network status and any prior authorization requirements. For NY Medicaid, most behavioral health visits do not require prior authorization.

Step 4: Complete the Evaluation. Bring photo ID, insurance card, and any relevant history (school records, prior evaluations, current medication list). NYC-based evaluations may include waitlists of 2-6 weeks at academic centers.

Step 5: Start Treatment. In New York, psychiatrists, PCPs, nurse practitioners, and physician assistants can prescribe ADHD medications. New York requires prescribers to check the I-STOP prescription monitoring registry before issuing controlled substance prescriptions.

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Local Resources FAQ

Is adult ADHD evaluation free with New York Medicaid?

Yes. New York Medicaid covers adult ADHD evaluation with $0 copay -- no prior authorization is required for most behavioral health visits. This includes clinical interviews, standardized assessments, and follow-up psychiatric visits. Contact your Medicaid managed care plan's behavioral health line for provider referrals.

How much does an ADHD evaluation cost upstate vs. NYC?

The cost difference is significant. In Manhattan, private neuropsychological evaluations typically range from $2,000 to $3,500. In Buffalo, Rochester, or Syracuse, the same evaluation may cost $500 to $1,500. University training clinics upstate offer the most affordable options at $100 to $400.

What is the Essential Plan and does it cover ADHD?

The Essential Plan is a New York-specific low-cost health plan for individuals earning 138-200% of the federal poverty level. Monthly premiums are $0 to $20, and the plan covers behavioral health services -- including ADHD evaluation and therapy -- with low copays. Apply through NY State of Health (nystateofhealth.ny.gov).

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Key Takeaways

• Private ADHD diagnosis in New York averages $2,000 USD -- NYC is among the most expensive markets nationally.
• Upstate evaluations are significantly more affordable ($500-$1,500).
• New York Medicaid offers $0 copays for all behavioral health services.
• Therapy rates range from $150/hr (LCSW) to $400/hr (Psychologist).
• Strong mental health parity laws (Timothy's Law) ensure comprehensive insurance coverage.
• The Essential Plan provides an affordable coverage option for those above the Medicaid threshold.