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Evaluation Cost Guide

Autism Evaluation Cost in Maine

In Maine, private-pay autism evaluations typically run $1,800–$4,500 (~$3,000 average). MaineCare covers evaluations fully for enrolled children under 21, and Maine's genuine Katie Beckett / TEFRA option lets middle-income families access MaineCare regardless of income. Maine Medical Center in Portland is the primary in-state center; Boston children's hospitals are common out-of-state options.

Quick Answer

In Maine, private-pay autism evaluations typically run $1,800–$4,500 (~$3,000 average). MaineCare covers evaluations fully for enrolled children under 21, and Maine's genuine Katie Beckett / TEFRA option lets middle-income families access MaineCare regardless of income. Maine Medical Center in Portland is the primary in-state center; Boston children's hospitals are common out-of-state options.

  • Private-pay range: $1,800-$4,500 (typical about $3,000).
  • Commercial insurance: $0–$1,500 depending on deductible and plan type.
  • Medicaid: covered with a typical copay of $0.

Private-pay (no insurance)

$1,800 – $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 and plan type

Typical out-of-pocket

Maine's autism insurance mandate requires state-regulated plans to cover autism services including evaluations. Self-funded ERISA plans are exempt — confirm your plan type with the Maine Bureau of Insurance.

Medicaid

$0

Typical copay

MaineCare covers diagnostic evaluations under EPSDT for enrolled children under 21. Families using the Katie Beckett / TEFRA eligibility category can access MaineCare regardless of family income for children with significant disabilities.

Wait Times

4–8 months

Private psychologist

Major center: 9–15 months (Maine Medical Center, Northern Light EMMC)

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
9–15 months (Maine Medical Center, Northern Light EMMC)
Private psychologist
4–8 months
Telehealth
4–8 weeks at telehealth-first practices; benefits from MaineCare telehealth parity

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 Maine

Maine Medical Center (MaineHealth) — Pediatric Specialty Care

nonprofit

Portland

Primary in-state diagnostic resource; accepts MaineCare.

Spurwink

nonprofitSliding scale

Portland and statewide

Accepts MaineCare; long-established Maine autism nonprofit.

Northern Light Eastern Maine Medical Center — Pediatric Specialty Clinic

nonprofit

Bangor

Primary developmental-pediatrics resource in northern Maine.

Katie Beckett / TEFRA category (MaineCare)

state fundedFree if eligible

Apply through MaineCare Member Services — children with qualifying disabilities access MaineCare regardless of family income.

Boston Children's Hospital — Autism Spectrum Center

nonprofit

Boston, MA

Common out-of-state referral destination for Maine families.

Related

Maine 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 Maine. Always confirm the latest quote directly with the provider before booking.

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