If you’ve been looking for an adult autism or ADHD evaluation and you live somewhere with a long wait (Raleigh, Nashville, Las Vegas, Chicago, Hartford, anywhere), you’ve probably already searched for “online psychological evaluation” or “telehealth ADHD testing.” And you’ve probably noticed something confusing: most psychologists’ websites say they only see clients in one or two states.
That’s because, until recently, that’s how psychology licensure worked. A psychologist licensed in Michigan could see Michigan clients. A psychologist licensed in Texas could see Texas clients. State lines were hard lines.
PSYPACT changed that for most of the country. This post explains what PSYPACT is, what it means if you’re considering an evaluation across state lines, and what it looks like in practice with us at Encore.
What PSYPACT is
PSYPACT stands for the Psychology Interjurisdictional Compact. It’s an interstate agreement among most U.S. states that lets a psychologist licensed in one participating state see clients in the other participating states for telehealth psychology services, including evaluation and therapy.
As of this writing, 40 states participate in PSYPACT. The list is updated as states join; the official directory is maintained by the Association of State and Provincial Psychology Boards at psypact.org.
The states that don’tcurrently participate include California, New York, Massachusetts, Oregon, and a handful of others, some of which have legislation pending. If you’re in one of those states, online evaluation across state lines under PSYPACT isn’t an option (though there are sometimes other pathways; we can talk through the specifics).
What it means in practice
For most readers, the practical meaning of PSYPACT is this: you can be evaluated by a psychologist who isn’t in your state, by video, with full legal authority, as long as both you and the psychologist are in PSYPACT-participating states at the time of the appointment.
That matters for a few reasons:
- Wait times.Adult autism evaluation in particular has very long waits in many states. Some of the clients we see from out of state have been on local waitlists for 12+ months. PSYPACT makes it possible to find a provider with a shorter wait, even if they’re across the country.
- Specialization. Some evaluation types (adult autism, adoption evaluations, certain learning-disorder profiles) have a much smaller pool of providers than the population suggests. PSYPACT widens the search radius.
- Continuity. If you start with a psychologist in one PSYPACT-participating state and you move to another PSYPACT-participating state, you can typically continue working together, unlike pre-PSYPACT, when a move usually meant starting over.
What an online evaluation actually looks like
A telehealth psychological evaluation under PSYPACT isn’t a watered-down version of an in-person one. The structure is the same:
- Intake by video
- Clinical interviewing by video
- Validated psychological measures administered through secure platforms, with the clinician walking through items and observing in real time
- Cognitive and (when relevant) academic achievement testing using established remote-administration protocols
- Observational measures for adult autism evaluation. There are adult-appropriate measures that work via video.
- A written report in the same format as an in-person evaluation
- A feedback session by video
The difference is logistical, not clinical. The measures used are validated for telehealth administration; the time commitment is the same; the report is the same; the diagnostic standards are the same.
For some evaluation types, particularly young children and certain neuropsych evaluations where in-person observation of motor or sensory function matters, in-person is the right call. We’ll tell you if that’s true for your situation.
What we offer under PSYPACT
At Encore, the evaluations we most often deliver virtually under PSYPACT:
- Adult autism evaluation. Our flagship service; we see clients across all 40 PSYPACT-participating states.
- Adult ADHD evaluation. Also widely available virtually.
- Adoption psychological evaluation. Most adoption agencies and attorneys accept virtual evaluations.
- Egg donor and fertility psychological evaluation. Most fertility clinics accept virtual evaluations.
We routinely see clients in North Carolina, Connecticut, Nevada, Illinois, and Tennessee, states where the local wait for adult autism or ADHD testing has been long enough that traveling across state lines (virtually) is the practical option.
What we don’t do under PSYPACT
A few honest limits worth naming:
- We don’t see children virtually.Child evaluation is in-person at our Bloomfield Hills office. Virtual evaluation isn’t the right modality for child cognitive and observational testing.
- We don’t operate in non-PSYPACT states.If you’re in California, New York, Massachusetts, Oregon, or another non-participating state, PSYPACT doesn’t apply. There are sometimes other licensure pathways (temporary practice authorizations, in-person visits in a PSYPACT state) but they’re case-by-case.
- We don’t do all evaluation types virtually. Some neuropsych evaluations, some learning-disorder evaluations, and any evaluation requiring specific in-person observational measures are better done in person.
The intake is where we figure out the right modality for your specific evaluation.
Insurance and PSYPACT
PSYPACT is about licensure, not insurance. Whether your insurance covers an evaluation by an out-of-state PSYPACT psychologist depends on:
- Whether the psychologist is in-network with your specific plan (most aren’t, across state lines)
- Whether your plan has out-of-network mental-health benefits
- Whether your plan reimburses telehealth at the same rate as in-person
For most of our out-of-state clients, the evaluation is private-pay, and we provide a superbill for clients with PPO plans that have out-of-network mental-health benefits. See our insurance coverage post for the longer answer on how that works.
How to find out if PSYPACT works for you
The simplest path:
- Confirm your state participates. Check the current list at psypact.org. Or just ask us at intake.
- Confirm the evaluation type can be done virtually. Most adult evaluations can; most child evaluations should be in person.
- Confirm the practicalities: insurance, deadline, scheduling. We work through that during the intake.
Where to start
If you’re in one of the 40 states that participate in PSYPACT and you’ve been searching for an adult autism, adult ADHD, or adoption evaluation with a manageable wait, the next step is an intake. We’ll confirm PSYPACT eligibility, confirm the evaluation type fits the modality, and walk through the timeline and cost.
