Two counties, two Medi-Cal plans, two access lines, and a habit among clinics of quoting a testing battery to anyone who says the word ADHD. The first appointment does not have to be the most expensive one.
The useful distinction is this: an ADHD diagnostic evaluation, a full psychological testing battery, and medication follow-up are three different services, and most adults should begin by asking for the first.¹ Full testing earns its cost when a clinician has to separate ADHD from a learning disorder, cognitive change or another complicated picture. Medication care needs a clinician who can prescribe and keep following you. The East Bay difference is which door you start at, and that depends on your county as much as your plan.
Name the decision before you book
| What you are trying to decide | Ask for this | A useful answer should include | Stop before paying if… |
|---|---|---|---|
| "Could this be ADHD?" | Adult ADHD diagnostic evaluation | A clinical interview, childhood history, effects in more than one part of life, and consideration of sleep, mood, substance use and medical causes | A questionnaire score is presented as the diagnosis |
| "Is there also a learning or cognitive problem?" | Psychological or neuropsychological testing consultation | The exact question the tests would answer, hours, billing codes, report and total estimate | The battery is sold as mandatory for every ADHD diagnosis |
| "I may want medication" | Evaluation with prescribing and follow-up | Who prescribes, how refills and side effects are handled, and the complete first-90-day cost | Medication is promised before an evaluation, or nobody owns follow-up |
Your East Bay route depends on your county and how care is paid for
If you have commercial insurance
Call the behavioral-health number on the card and ask for "an in-network adult ADHD diagnostic evaluation — not automatically a full testing battery." Then ask four questions: who can complete the diagnosis, whether prior authorization is required, what your cost is for the evaluation and the follow-up, and whether the plan will arrange an out-of-network appointment at in-network cost if nobody in network can see you.
California's timely-access standard is generally 10 business days for a non-urgent appointment with a non-physician mental-health provider, subject to clinical exceptions and plan type. A directory is not proof that an appointment exists — ask the plan to find you one, and write down the call reference number.² If nobody in-network has an opening →
If you have Alameda Alliance for Health Medi-Cal
One sentence on the Alliance's own benefits page decides how you open the call: "Prior authorization (approval) is not required for routine outpatient behavioral health care services."³ So the first ask is an appointment, not permission.
Member Services is 1-510-747-4567 or toll-free 1-877-932-2738, TTY 711.³ Use careful words: "I need an adult ADHD diagnostic evaluation. Which network provider can complete that, and what is the soonest appointment you can locate for me?"
The Alliance also describes the two-tier structure plainly: where screening indicates specialty mental health services are needed, your doctor refers you to the county for assessment.³ That is the moment the county line below becomes relevant — not before.
If you are in Alameda County and unsure where to start
The county's ACCESS line is (800) 491-9099, described on the county's own page as a "24/7/365 telephonic referral line" and "the point of entry for behavioral health services and referrals."⁴
Say what you need and listen to which system takes it: "I need an adult ADHD diagnostic evaluation. Which part of the system handles that for me, and who is accepting referrals?" A referral line is an access door, not a promise of a county ADHD clinic. If one door sends you to the other, write down the date, the name and the reason.
If you have Contra Costa Health Plan Medi-Cal
CCHP's member line is 1-877-661-6230, and it is worth knowing the menu before you dial: Option 2 is Member Services, Monday to Friday 8am–5pm, Option 4 is mental health referrals and authorizations, and Option 1 is a 24-hour advice nurse.⁵ Choosing Option 4 the first time saves a transfer.
If you are in Contra Costa County and unsure where to start
The county's 24/7 ACCESS line is 1-888-678-7277. Contra Costa describes it as a place to "get screened over the phone for mental health or substance use treatment," to ask questions about services, to get help filing a grievance or appeal, and to reach interpretation in any language.⁶
The grievance detail is the useful one. If a plan or a county service has told you no and you think that was wrong, the same number that screens you can help you file. How an appeal actually works →
If you have no insurance, or do not know what you have
Call your county line — (800) 491-9099 in Alameda, 1-888-678-7277 in Contra Costa — and ask about eligibility before you agree to private testing.⁴ ⁶ Neither county publishes a guarantee of free ADHD testing, and neither line will pretend otherwise if you ask directly.
If you choose private care, ask for a written good-faith estimate covering the diagnostic visit, any testing, the report, the feedback meeting and follow-up. Compare two complete ADHD evaluation quotes →
Telehealth can be real care. The five checks still matter.
An online evaluation is not valid merely because it is convenient, and not invalid merely because it is online. Confirm the individual clinician's California licence, what happens beyond a checklist, what written document you receive, who provides follow-up, and the total first-90-day price.
Medication makes the arrangement more fragile. California requires an appropriate examination and a legitimate medical reason for an internet prescription, and the federal controlled-medication telehealth flexibilities are temporary, currently running through December 31, 2026, so this section is reviewed every 90 days.⁷ ⁸ Use the full online-evaluation check →
Make one call before buying a battery
Use this sentence:
"I am looking for an adult ADHD diagnostic evaluation. Before I book, please tell me whether this is an interview or a full testing battery, who completes the diagnosis, what the total price is, what document I receive, and who handles treatment afterwards."
Then bring a one-page record of what is happening now, what you remember from childhood, where the difficulty shows up, and what else might be affecting attention. Prepare that page privately →
Two neighbouring versions of this page exist, because the doors differ by county: the South Bay → · San Francisco →
Q&A
Do I need neuropsychological testing to be diagnosed with adult ADHD? Usually, no. A qualified clinician can often diagnose ADHD through a thorough clinical evaluation. Testing earns its cost when there is another question the interview cannot answer.¹
Do I need approval from Alameda Alliance before an outpatient appointment? Not for routine outpatient behavioral health care, by the Alliance's own statement — prior authorization is not required for those services.³ Ask for the appointment rather than for permission.
Does the county ACCESS line diagnose ADHD? No. Alameda describes its line as a referral line and a point of entry; Contra Costa describes its line as screening and connection.⁴ ⁶ Ask which plan or county service is responsible for your evaluation.
I live in one county and work in the other. Which line do I use? The county where you live is the one that decides your Medi-Cal specialty mental health access. Use your home county's line, and say where you live in the first sentence.
Our therapist directory: See its current status →
Sources
- National Institute of Mental Health, "ADHD: What You Need to Know" — diagnostic elements and differential assessment — nimh.nih.gov.
- California Department of Managed Health Care, Timely Access to Care — appointment standards and exceptions — dmhc.ca.gov.
- Alameda Alliance for Health, Medi-Cal benefits and covered services — "Prior authorization (approval) is not required for routine outpatient behavioral health care services," the member and toll-free numbers, and referral to the county for specialty mental health services — alamedaalliance.org.
- Alameda County Health, Behavioral Health ACCESS, Support and Referrals — "24/7/365 telephonic referral line" and "the point of entry for behavioral health services and referrals" — health.alamedacountyca.gov.
- Contra Costa Health Plan, contact information for members — the member line and its options, including mental health referrals and authorizations — cchealth.org.
- Contra Costa Health, Behavioral Health Access Line — 24/7 screening "for mental health or substance use treatment," grievance and appeal help, and interpretation — cchealth.org.
- Medical Board of California, consumer FAQ on internet prescribing and telehealth — mbc.ca.gov.
- U.S. Drug Enforcement Administration, temporary controlled-medication telemedicine flexibilities through December 31, 2026 — dea.gov.
Local access facts and numbers checked 11 September 2026. Clinical review is not yet claimed.
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