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Evaluation Cost Guide

Autism Evaluation Cost in West Virginia

In West Virginia, a private-pay autism evaluation typically runs $1,500–$4,000. WV's insurance mandate covers state-regulated plans with $0–$1,200 out-of-pocket typical. Medicaid fully covers evaluations for children under 21 via EPSDT. Many families travel to Nationwide Children's, Cincinnati Children's, UPMC Pittsburgh, or UVA for specialty diagnostics.

Quick Answer

In West Virginia, a private-pay autism evaluation typically runs $1,500–$4,000. WV's insurance mandate covers state-regulated plans with $0–$1,200 out-of-pocket typical. Medicaid fully covers evaluations for children under 21 via EPSDT. Many families travel to Nationwide Children's, Cincinnati Children's, UPMC Pittsburgh, or UVA for specialty diagnostics.

  • Private-pay range: $1,500-$4,000 (typical about $2,500).
  • Commercial insurance: $0–$1,200 depending on deductible.
  • Medicaid: covered with a typical copay of $0.

Private-pay (no insurance)

$1,500 – $4,000typical: ~$2,500

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

Commercial Insurance

$0–$1,200 depending on deductible

Typical out-of-pocket

WV's autism insurance mandate requires state-regulated commercial plans to cover autism diagnosis and treatment including ABA. Self-funded ERISA plans are exempt — confirm your plan type.

Medicaid

$0

Typical copay

WV Medicaid (administered by the Bureau for Medical Services) covers diagnostic evaluations under EPSDT for enrolled children under 21. Katie Beckett-enrolled children have the same benefit regardless of family income.

Wait Times

4–8 months

Private psychologist

Major center: 9–15 months (WVU Medicine Children's, CAMC Women and Children's, Marshall Health)

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 (WVU Medicine Children's, CAMC Women and Children's, Marshall Health)
Private psychologist
4–8 months
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 West Virginia

WVU Center for Excellence in Disabilities (CED)

universitySliding scale

Morgantown

WV's UCEDD; interdisciplinary evaluations and training-clinic sliding scale.

Marshall University Autism Training Center

university

Huntington

Family support, training, and evaluation referral.

Prestera Center

nonprofit

Charleston / Huntington region

Community behavioral health organization; accepts Medicaid.

Nationwide Children's Hospital (Columbus, OH)

university

Columbus, OH

Common out-of-state referral for northern and eastern WV families.

UPMC Children's Hospital of Pittsburgh

university

Pittsburgh, PA

Common out-of-state referral for northern WV families.

Related

West Virginia 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 West Virginia. Always confirm the latest quote directly with the provider before booking.

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