Adult Autism & ADHD Assessment via Telehealth

Autism and ADHD testing for late-diagnosed and high-masking adults in Maryland, DC, Virginia, and Massachusetts

You've got 40 browser tabs open about it.

You've taken the online quizzes.

TikTok and Instagram reLENTlessly feed you content about neurodivergence.

You relate to a suspicious amount of it…but you trust experts…not algorithms.

At some point, a research deep dive turns into wanting a real answer from someone who knows what autism and ADHD look like, especially in adults who spent decades making it look fine.

That's what we do.

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At a glance

OutPsych offers autism and ADHD assessments for adults 18 and older by telehealth in Maryland, DC, Virginia, and Massachusetts. Assessments are run by psychiatric nurse practitioners Jess Romeo and Janine Michaelson, take 3 to 4 visits over 4 to 6 weeks, and cost $1,600 to $2,400 in total. You can assess for autism, ADHD, or both (AuDHD). Afterward, you can continue with the same team for medication management if you’d like to.

Who should get an adult autism or ADHD assessment?

An adult assessment makes sense when you've wondered for a while whether autism or ADHD explains patterns that other diagnoses never quite covered. You're far from the only adult asking.

The CDC estimates that about 6% of US adults have ADHD, and roughly half of them were first diagnosed as adults (Staley et al., MMWR, 2024). About 2% of US adults are autistic, most of them undiagnosed (Dietz et al., Journal of Autism and Developmental Disorders, 2020).

Some of these might sound familiar:

You got good grades, so nobody looked twice. Things fell apart in grad school, at your first real job, or the year you became a parent.

Rest doesn't restore you. It just keeps you from falling further behind.

Your "depression" has been through three SSRIs and never really budged, but the side effects were ROUGH.

You've been called too much, too intense, too sensitive. Also somehow too flat? It’s legitimately confusing to keep up.

Your queerness or your gender became the only lens anyone used, and everything else got filed under it.

Things got noticeably harder around perimenopause, after giving birth, or after a hormone change, and now you're wondering whether something was there all along.

None of these rules in a diagnosis. But they all deserve a closer look.

How is an OutPsych assessment different from other ADHD or autism testing?

Our specialty is telling autism and ADHD apart from the diagnoses they get mistaken for. Many of the adults we assess already have a chart full of labels that never quite fit.

We take a middle path. On one side, careful clinical interviewing and validated questionnaires. On the other, an understanding of neurodivergence as a way of being wired, not a list of defects.

We need both to get it right.

These are questions we find ourselves answering most often:

  • Obdurate routines, repetitive checking, and distress when things are "off" can come from obsessions and compulsions. They can also come from an autistic need for predictability. The treatments are different, so the distinction matters.

  • Both can look like exhaustion, withdrawal, and losing skills you used to have. Burnout usually follows long stretches of masking and sensory overload, and it doesn't respond to antidepressants the way depression can.

  • We regularly see adults diagnosed with bipolar disorder by clinicians who never considered an autistic or ADHD neurotype. Emotional intensity, meltdowns, hyperfocus bursts, and irregular sleep can all look like mood episodes from the outside. Sometimes the bipolar diagnosis holds up. Sometimes it doesn't, and knowing which changes your whole treatment plan.

  • Trauma and ADHD can produce similar attention and regulation problems, and plenty of people have both.

    Hormones and chronic illness can blur the picture too. Attention can get worse at certain points in the menstrual cycle or in perimenopause. Conditions like POTS, hypermobility, MCAS, and sleep disorders often show up alongside neurodivergence. Neither one cancels out an autism or ADHD diagnosis. (This is where a practice that also treats hormones earns its keep. More in What Is Psychoendocrine Care?)

The Process

What happens during an adult autism or ADHD assessment?

An OutPsych assessment has five steps: a free consultation call, online intake questionnaires, 3 to 4 interview visits, and a results visit with an optional written report. Most people finish in 4 to 6 weeks from their first call.

  • Click any "Book a free consultation" button. After you book, you'll get a short HIPAA-secure form where you can tell us about what led you here, and also about any communication needs or preferences, like camera off, extra processing time, or anything else that helps.

  • A 15 to 20 minute call by phone or Zoom, depending on your provider. (We have preferences too, and we accommodate ourselves as well.)

    We'll hear what's bringing you in, answer your questions, and make sure your question is one we're the right people to answer. Some are better suited to a neuropsychologist or other provider type, and we'll tell you if that's the case. If it's a fit, we'll schedule your first visits.

  • You'll get an electronic packet of forms and standardized questionnaires. Plan on 45 to 90 minutes. Everything auto-saves, so you don't have to finish in one sitting. One request: once you start a standardized questionnaire, try to finish that one before you stop.

  • Expect 3 to 4 video visits of 50 to 60 minutes each, spaced 2 days to a week apart. We'll ask about your history, how your days actually go, what's hard, and what you're good at.

    With your permission, we may also talk with your therapist, family, friends, or other providers. That part is optional. We may also send a few extra questionnaires to fill gaps or help tell similar-looking diagnoses apart.

  • We'll walk you through what we found in a feedback visit. If you want a written report, it covers your diagnoses and how masking and other adaptations helped you get through environments that weren't built for you. It also includes recommendations for your therapist, support for school or work accommodations, and practical strategies for daily life.

    We don't guarantee any specific diagnosis. We do see high-masking autistic and ADHD adults every day, though, so subtle or masked traits won’t get overlooked.

  • Since we're prescribing providers, you don't have to stop at a diagnosis and a referral out. If you want medication management, gender-affirming care, or other care within our specialties, you can keep working with the same team that just spent a month getting to know you.

Book your free initial consultation

  • An adult autism or ADHD assessment at OutPsych costs $1,600 to $2,400 in total, depending on how many visits you need. We're out of network, but we provide superbills and will submit out-of-network claims to your insurance as a courtesy. Many plans reimburse part of the cost, so it's worth checking your out-of-network benefits.

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  • Yes. OutPsych specializes in queer and trans care, and our providers have lived queer and/or trans experience. You'll get your correct name and pronouns from the first form. You'll also get clinicians who understand how living under cis-heteronormativity shapes the way neurodivergence shows up and gets overlooked.

Frequently Asked Questions

  • Most assessments take about 4 to 6 weeks from the consultation call to results. That covers 45 to 90 minutes of online forms, 3 to 4 visits of 50 to 60 minutes, and a feedback visit.

  • Yes. Autism and ADHD are often mistaken for bipolar disorder, OCD, and depression, especially in adults who mask. Sorting out those differences is our specialty, including re-examining bipolar diagnoses that were made without considering neurotype.

  • Yes. Autism and ADHD often occur together (sometimes called AuDHD), and we can assess for one or both in the same assessment.

  • Yes. Our assessments rely on clinical interviews and standardized questionnaires, both of which work well over video. If your question needs in-person neuropsychological testing, we'll tell you on the consultation call.

  • Not everyone does. People usually come to us because they want to discuss accommodations, explore medication, want clarity after years of misdiagnosis, or want a clinician to weigh in on what they've already worked out.

  • Yes, and many of our patients do. A trauma history shapes how we interpret some of your answers. It doesn't take a neurodevelopmental diagnosis off the table.

  • Our written reports are designed to support accommodation requests. Each employer and school sets its own documentation rules, so check with them about what they need.

  • If it's clinically appropriate and you want to go that route, you can continue with us for medication management after the assessment.

  • OutPsych is out of network. We provide superbills for the visits, using CPT codes that are used commonly by psychiatric and psychotherapy providers. We can even submit courtesy out-of-network claims for you. How much you get back depends on your plan's out-of-network benefits. You can check that for yourself here: https://practitioner.reimbursify.com/verifast?ec=1E8H3J1A0J

  • No referral is needed. You can book a free consultation directly. (If someone recommended us, we'd love to know who, so we can thank them.)

  • No. OutPsych assesses adults 18 and older only.

  • All assessments happen by telehealth for adults located in Maryland, Washington DC, Virginia, or Massachusetts at the time of their visits.

You’ve done a lot of research on yourself already.

Let’s compare notes.

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