The pediatrician is often the first contact for a parent seeking help for a child with symptoms that may be caused by attention-deficit/hyperactivity disorder (ADHD). Though pediatricians are well-qualified to diagnose and provide medical management of this condition, there are some barriers to payment that may need to be addressed before providing these time-consuming services. Some insurance plans direct all claims with a diagnosis reported by International Classification of Diseases, Ninth Revision, Clinical Modification codes 290–319 to their mental and behavioral health benefits system. Because pediatricians are generally not included in networks for mental and behavioral health plans, this can create delays or denials of payment. This is not always the case, though, and with a little preventive footwork, practices can identify policy guidelines for plans that are commonly seen in the practice patient population.

The first step in identifying coverage for services to diagnose or treat ADHD is to...

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