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Evaluation Cost Guide

Autism Evaluation Cost in Illinois

In Illinois, a private-pay autism evaluation typically costs $2,000–$4,500 (~$3,000 average). With commercial insurance under the state mandate, out-of-pocket runs $0–$1,500 through age 18. HealthChoice Illinois Medicaid covers evaluations fully for children under 21.

Quick Answer

In Illinois, a private-pay autism evaluation typically costs $2,000–$4,500 (~$3,000 average). With commercial insurance under the state mandate, out-of-pocket runs $0–$1,500 through age 18. HealthChoice Illinois Medicaid covers evaluations fully for children under 21.

  • Private-pay range: $2,000-$4,500 (typical about $3,000).
  • Commercial insurance: $0–$1,500 depending on deductible.
  • Medicaid: covered with a typical copay of $0.

Private-pay (no insurance)

$2,000 – $4,500typical: ~$3,000

For a comprehensive pediatric evaluation (history, ADOS-2, cognitive testing, written report). Updated 2026-04-21.

Commercial Insurance

$0–$1,500 depending on deductible

Typical out-of-pocket

The Illinois autism mandate (215 ILCS 5/356z.14) requires coverage of diagnostic evaluations on state-regulated plans through age 18, within the $36,000 annual aggregate cap. Self-funded ERISA plans (common with large employers) are exempt — confirm your plan type before scheduling.

Medicaid

$0

Typical copay

HealthChoice Illinois Medicaid covers evaluations under EPSDT for enrolled children under 21. Prior auth is typically required for subsequent ABA services but not for the evaluation itself.

Wait Times

3–6 months in Chicago metro; 2–4 months downstate

Private psychologist

Major center: 9–18 months (Lurie Children's, Rush AARTS, UIC, Shirley Ryan AbilityLab)

Editorial Review

Cost ranges on this page are directional estimates compiled from published price lists, public fee schedules, and manual review.

Actual charges depend on the provider, testing scope, insurance contract, and your deductible or network status. Confirm fees and prior authorization requirements before scheduling.

Last reviewed 2026-04-21 by Autism Hearts Editorial Team

Wait Times by Provider Type

Major medical center
9–18 months (Lurie Children's, Rush AARTS, UIC, Shirley Ryan AbilityLab)
Private psychologist
3–6 months in Chicago metro; 2–4 months downstate
Telehealth
4–8 weeks at telehealth-first practices

Getting on multiple waitlists simultaneously is strongly recommended. Telehealth and private-practice waits are often significantly shorter than academic medical centers.

Low-Cost & Free Evaluation Options in Illinois

UIC Institute on Disability and Human Development (IDHD)

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Chicago

Sliding-scale evaluations through the Developmental Disabilities Family Clinics.

Rush AARTS Center

university

Chicago

Research studies may offer free or low-cost evaluations for qualifying participants.

SIU School of Medicine — Pediatric Resource Center

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Springfield

The Hope Institute for Children and Families

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Springfield

Easterseals DuPage & Fox Valley

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Chicago suburbs

Accepts Medicaid and offers need-based financial assistance.

Related

Illinois Medicaid coverage details

Full breakdown of HCBS waivers, ABA benefit rules, and the state insurance mandate.

View Medicaid →

Sources

These sources support the current pricing and coverage context for Illinois. Always confirm the latest quote directly with the provider before booking.

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