How long does a neuropsychological examination last
and how much does it cost?

Most outpatient clinical examinations last about 3 to 7 hours. These usually begin with an interview of the patient and another person who is familiar with their functioning and symptoms. The interview lasts about 60 to 90 minutes. Testing usually is completed in 3 to 5 hours. The neuropsychologist then scores and interprets test results, reads additional medical or other records and prepares a summary report. These services usually consume an additional hour or more of the neuropsychologist's time.

Forensic examinations are usually more extensive and require a considerable expenditure of time and energy. In our experience, most civil or criminal cases average anywhere from 10 to 40 hours from intake to final report, depending on the complexity of the case, referral questions to be answered and the volume of records to be reviewed. We prefer to examine patients on at least two occasions or more if possible. Usually, the individual will be scheduled for two consecutive days of interview and examination.

In the United States, charges for neuropsychological services can range from $ 150 - 300 or more per hour. Some neuropsychologists charge more for forensic than clinical examinations. Charges are commonly based on the amount of time involved in testing, interview, record review, staffing and report preparation. Reduced rates are sometimes negotiated  for services provided under contractual agreement. Neuropsychological services are billed under neurology codes when appropriate. Neuropsychological services are covered by Medicare and many other insurance carriers.

Definition of a Clinical Neuropsychologist

The first clinical neuropsychologists were research scientists associated with experimental laboratories or clinicians who worked with brain injured individuals in Veterans Administrations or psychiatric hospitals. Modern neuropsychological assessment and intervention procedures evolved from the work of psychologists and neurologists working in these settings in the 1940's and 50's. Ward Halstead and Ralph Reitan are two founding fathers of modern American neuropsychology. They developed the Halstead-Reitan Neuropsychological Test Battery which has enjoyed widespread use in the United States over several decades because of its sensitivity to several dimensions of brain damage and its strong clinical and empirical validity.

Education and training in clinical neuropsychology evolved along with the specialty and its associated science base. Formal training in professional and clinical neuropsychology was not widely available until the 1990's with the first programs emerging in the mid to late 1980's. In the absence of formal specialty training, most individuals who practiced neuropsychology during these early years were mentored by a small group of researchers and clinicians. Indeed, clinical neurpsychology was not formally recognized as a specialty by the American Psychological Association (APA), until 1998. Prior to the late 1990's, there was no widely recognized and accepted description of integrated education and training in the specialty of clinical neuropsychology. The Houston Conference on Specialty Education and Training in Clinical Neuropsychology, which convened in 1997, resulted in the publication of the first organized training guidelines for the specialty although its work product remains the focus of some debate.