Free and low cost adult autism assessments

Being realistic about free

In countries with national health services, an adult autism assessment may be free at the point of use, though waits can be long. In the United States, almost every route involves some cost, and truly free assessments are rare. That said, the gap between a full private fee and what many people actually pay can be large, and several options bring the cost down a lot.

A note of caution: be wary of any website offering a free online autism diagnosis. A real diagnosis requires a licensed clinician, a detailed history and clinical judgment. Free online quizzes, including ours, are tools for reflection and preparation.

Route 1: Medicaid

If your income is low or you have a disability, Medicaid may cover an adult evaluation with little or no cost to you. Eligibility and benefits vary by state. Our Medicaid guide explains how to ask your plan and find a clinician who accepts it.

• Adult autism testing with Medicaid or MedicareHow adults can seek an autism evaluation with Medicaid, Medi-Cal or Medicare: what to ask your plan, finding a provider, and what to do if you are refused.

Route 2: Community health centers

Federally funded community health centers charge based on income and provide primary care plus referrals to mental health services. They may not perform autism assessments themselves, but a clinician there can refer you and may know local low cost options.

You can search for a nearby center using the official HRSA locator.

Route 3: University training clinics

Many universities with doctoral programs in clinical psychology run training clinics open to the public. Assessments are carried out by graduate students under close supervision of licensed psychologists. Fees are often lower than private practice, and some use sliding scales. Waits can still be long, and not every clinic assesses adults for autism, so ask. Search for your nearest university's psychology department and look for a psychological services center or training clinic.

Route 4: Sliding scale private practices

Some private psychologists reserve a number of reduced fee slots for people with lower incomes. They may not advertise this, so ask directly: do you offer a sliding scale or reduced fee for adult autism assessments? Be prepared to share income information.

Route 5: Research studies

Universities and hospitals running autism research sometimes include a diagnostic assessment as part of a study. Participation may be free, and sometimes includes a summary of findings. Be aware that research assessments may not give you a formal diagnosis you can use elsewhere, may not include a full report, and you will need to meet the study's criteria. Read the consent information carefully and ask what you will receive.

Route 6: Your current mental health care

If you already see a psychiatrist or psychologist through insurance, a public mental health service or a community clinic, ask whether they can assess for autism or refer you to a colleague who can. Some clinicians can incorporate an autism evaluation into existing care, which may cost less than starting fresh elsewhere.

Other ways to reduce cost

• Ask about payment plans to spread the cost over months.
• Use a health savings or flexible spending account if you have one.
• Ask out-of-network clinicians for a superbill to claim partial reimbursement.
• Check whether a vocational rehabilitation agency in your state can help fund an evaluation if it relates to employment.
• Ask a college disability or counseling office about low cost assessment if you are a student.
• Contact local autism organizations, which sometimes know of grants or low cost clinics.

Questions to ask any low cost option

• Do you assess adults for autism, or mainly children?
• Who carries out the assessment, and who signs the final report?
• What is the total cost, and is there a sliding scale?
• How long is the current wait?
• Will I receive a written report and a feedback session?

Getting clear answers up front saves time. A cheaper option that does not assess adults, or that will not give you a written report, may not meet your needs.

What to do while you save or wait

You do not need a diagnosis to start understanding yourself or making changes. Many adults read about autistic experience, connect with autistic communities online, try sensory adjustments at home and work, and keep a log of patterns to share with a clinician later. Some workplaces offer adjustments without a formal diagnosis if you explain your needs.