Cost of IEE exceeds 'reasonable & customary'

[Anonymous]

We're in a disagreement with the school regarding assessments/recommendations. We're in the process of getting an IEE done through Stixrud. However, the cost at Stixrud is greater than what the county says in 'reasonable & customary'. The research I've done seems to indicate that once the school has agreed to an IEE, it's to be done at no cost to the parent as long as the evaluators meet the criteria set forth by the school. Stixrud certainly meets that criteria. Can I expect the county to fully reimburse us? Anyone been through this? FWIW, DC is a complex case. Thanks.

[Anonymous]

Has the county actually agreed to an IEE?

[Anonymous]

Anonymous wrote:Has the county actually agreed to an IEE?

Yes, the county as agreed to the IEEs.

[Anonymous]

I would think that one of the "criteria set by the school" would be cost of the evaluation. Stixrud is wonderful, but his evaluations are not cheap.

[Anonymous]

Anonymous wrote:We're in a disagreement with the school regarding assessments/recommendations. We're in the process of getting an IEE done through Stixrud. However, the cost at Stixrud is greater than what the county says in 'reasonable & customary'. The research I've done seems to indicate that once the school has agreed to an IEE, it's to be done at no cost to the parent as long as the evaluators meet the criteria set forth by the school. Stixrud certainly meets that criteria. Can I expect the county to fully reimburse us? Anyone been through this? FWIW, DC is a complex case. Thanks.

What is the exact language that you found indicating this? Please copy and paste it here so we can read it and give you a response. Thanks.

[Anonymous]

What does the county think is reasonable & customary and what does he charge? I'm just curious--I have a hunch that what the county wants to pay is an amount much lower than any decent practictioner charges.

[Anonymous]

Anonymous wrote:

Anonymous wrote:We're in a disagreement with the school regarding assessments/recommendations. We're in the process of getting an IEE done through Stixrud. However, the cost at Stixrud is greater than what the county says in 'reasonable & customary'. The research I've done seems to indicate that once the school has agreed to an IEE, it's to be done at no cost to the parent as long as the evaluators meet the criteria set forth by the school. Stixrud certainly meets that criteria. Can I expect the county to fully reimburse us? Anyone been through this? FWIW, DC is a complex case. Thanks.

What is the exact language that you found indicating this? Please copy and paste it here so we can read it and give you a response. Thanks.

There are numerous writings about this, including WrightsLaw http://www.wrightslaw.com/blog/?p=8697 . I'm not looking for an interpretation of the law but what people have experienced with IEEs that exceeded the cap set by the school system. As many of us have experienced, the law may say one thing but the school district may do something different. Thanks.

[Anonymous]

Anonymous wrote:I would think that one of the "criteria set by the school" would be cost of the evaluation. Stixrud is wonderful, but his evaluations are not cheap.

The criteria referred to are the qualifications of the evaluator to conduct the assessments, not the cost.

[Anonymous]

Anonymous wrote:What does the county think is reasonable & customary and what does he charge? I'm just curious--I have a hunch that what the county wants to pay is an amount much lower than any decent practictioner charges.

The cap set by the county is $900 for an education evaluation, $1,200 for a psychological evaluation and $400 for a speech/language evaluation. The Stixrud range for neuro-psychological testing is $2,960-$4,035.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would think that one of the "criteria set by the school" would be cost of the evaluation. Stixrud is wonderful, but his evaluations are not cheap.

The criteria referred to are the qualifications of the evaluator to conduct the assessments, not the cost.

I find this hard to believe. What's to stop me from setting up shop charging $100,000 an eval, and encouraging parents who are pissed at their school to choose me as a form of revenge?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We're in a disagreement with the school regarding assessments/recommendations. We're in the process of getting an IEE done through Stixrud. However, the cost at Stixrud is greater than what the county says in 'reasonable & customary'. The research I've done seems to indicate that once the school has agreed to an IEE, it's to be done at no cost to the parent as long as the evaluators meet the criteria set forth by the school. Stixrud certainly meets that criteria. Can I expect the county to fully reimburse us? Anyone been through this? FWIW, DC is a complex case. Thanks.

What is the exact language that you found indicating this? Please copy and paste it here so we can read it and give you a response. Thanks.

There are numerous writings about this, including WrightsLaw http://www.wrightslaw.com/blog/?p=8697 . I'm not looking for an interpretation of the law but what people have experienced with IEEs that exceeded the cap set by the school system. As many of us have experienced, the law may say one thing but the school district may do something different. Thanks.

That Wrightslaw page is confusing. At one point it says:

Wrightslaw wrote:

There is no provision in the law that allows districts to limit the cost or that requires parents to pay a portion of the cost of an Independent Educational Evaluation (IEE). - See more at: http://www.wrightslaw.com/blog/?p=8697#sthash.Ctfjwd2t.dpuf

although it qualifies it by saying that it's based on IDEA 97 (as if 10 years wasn't long enough to review IDEA 2004) and then later it says

Wrightslaw wrote:

It is not inconsistent with IDEA for a district to publish a list of the names and addresses of evaluators that meet agency criteria, including reasonable cost criteria. - See more at: http://www.wrightslaw.com/blog/?p=8697#sthash.Ctfjwd2t.dpuf

[Anonymous]

Anonymous wrote:

That Wrightslaw page is confusing. At one point it says:

Wrightslaw wrote:

There is no provision in the law that allows districts to limit the cost or that requires parents to pay a portion of the cost of an Independent Educational Evaluation (IEE). - See more at: http://www.wrightslaw.com/blog/?p=8697#sthash.Ctfjwd2t.dpuf

although it qualifies it by saying that it's based on IDEA 97 (as if 10 years wasn't long enough to review IDEA 2004) and then later it says

Wrightslaw wrote:

It is not inconsistent with IDEA for a district to publish a list of the names and addresses of evaluators that meet agency criteria, including reasonable cost criteria. - See more at: http://www.wrightslaw.com/blog/?p=8697#sthash.Ctfjwd2t.dpuf

I don't have an answer for the OP, but I don't think the two sentences cited above are inconsistent with each other. A school district is free to publish a list -- perhaps to offer guidance, perhaps to encourage the use of those practitioners -- but cannot require the use of the people on that list.

OP, has the school given you something in writing that limits the cost of the IEE? What does that cite to -- a law, policy, regulation, something else?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

That Wrightslaw page is confusing. At one point it says:

Wrightslaw wrote:

There is no provision in the law that allows districts to limit the cost or that requires parents to pay a portion of the cost of an Independent Educational Evaluation (IEE). - See more at: http://www.wrightslaw.com/blog/?p=8697#sthash.Ctfjwd2t.dpuf

although it qualifies it by saying that it's based on IDEA 97 (as if 10 years wasn't long enough to review IDEA 2004) and then later it says

Wrightslaw wrote:

It is not inconsistent with IDEA for a district to publish a list of the names and addresses of evaluators that meet agency criteria, including reasonable cost criteria. - See more at: http://www.wrightslaw.com/blog/?p=8697#sthash.Ctfjwd2t.dpuf

I don't have an answer for the OP, but I don't think the two sentences cited above are inconsistent with each other. A school district is free to publish a list -- perhaps to offer guidance, perhaps to encourage the use of those practitioners -- but cannot require the use of the people on that list.

OP, has the school given you something in writing that limits the cost of the IEE? What does that cite to -- a law, policy, regulation, something else?

I didn't post the whole page, but further down it says that if a family wants an evaluator not on the list they can request it and the district can either allow it or go to Due Process.

[Anonymous]

Anonymous wrote:

Anonymous wrote:What does the county think is reasonable & customary and what does he charge? I'm just curious--I have a hunch that what the county wants to pay is an amount much lower than any decent practictioner charges.

The cap set by the county is $900 for an education evaluation, $1,200 for a psychological evaluation and $400 for a speech/language evaluation. The Stixrud range for neuro-psychological testing is $2,960-$4,035.

All these amounts are very low, but the speech/language is laughable. Several years ago ours was $1100; I imagine it's even more now.

Of course, the amounts for psych and ed are laughable too, but at least if you add them together you get $2100. It's interesting that there is no breakout of cost for psych vs. neuropsych. IME, neuropsych assessments cost more than assessments by those who are merely "psychologists". That's not surprising because neuropsychologists have more training that psychologists and thus can charge more. (I've just my own avery small anecdotal sample.) My insurance company doesn't distinguish between psych and neuropsych generally and doesn't really cover the latter. It might be worth calling around and getting prices/test lists for some "educational psychologists" for comparison with what Stixrud is doing. Maybe you can point to the difference in testing in order to support Stixrud's cost.

We chose to use Stixrud because they did some objective, normed, standardized non-language-based testing for attention and executive functioning. In our situation we were concerned about making the differential diagnosis between auditory processing, language-based learning disability and ADHD. All of these have overlapping symptoms. The main way the school or educational psychologist "diagnoses" ADHD is through checklists filled out by the teacher and parent. These checklists identify problem behaviors but don't really identify the differential underlying causes. We already knew that our child had a language disorder, so we really needed the objective testing piece for ADD/executive dysfunction. I share this because it's an example of why a particular case is "unusually complicated" and thus may justify a higher cost for testing.

Unfortunately, we paid privately, so I don't have personal experience with the process.

[Anonymous]

I have no personal experience with this, but.....

You might want to read pages 242-243 of this 2009 law journal article, where cost containment/limitation of reimbursement is discussed. http://www.law.seattleu.edu/Documents/aljho/resources/ZirkelIEEArticle38JLE223.pdf

It seems, even though IDEA addresses IIEs (see http://idea.ed.gov/explore/view/p/,root,regs,300,E,300%252E502,) and says in 300.502e2 that no limitations other than what is in subsection e1 can be put on IIEs at public expense, the DoE has gone ahead and "interpreted" that to mean that school systems can limit by cost as long as "(1) said maximum allows a choice among qualified professionals in the area by targeting unreasonably excessive fees rather than being limited to the average fee customarily charged in that area; and (2) it allows exceptions for justified unique circumstances."


In your situation, I would write a letter back to the school system which says 1) why the cost limitation is artificially low and unreasonably restricts your choice of tester and 2) why your child's case is unique enough to justify an exception.