Cost of ADHD Medication Monitoring Tests During Titration
If you retest a patient with a continuous performance test (CPT) at baseline and after each of four dose changes, that five-test course costs anywhere from $0 to $340 or more at list price, depending on the platform. The spread comes from pricing models: per-test credits, per-use scoring fees, hardware plus credits, and flat subscriptions. Below we work through the cost of ADHD medication monitoring tests per patient and per year for each vendor that publishes prices, with the arithmetic shown. AxonCPT is one of the platforms compared; we publish this article.
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Disclosure: AxonCPT publishes this article. Every competitor price is the list price on that vendor’s website, accessed September 27, 2026, linked in the text. Taxes, shipping, bulk discounts, and contract pricing can differ. Confirm current pricing with each vendor.
Why titration changes the cost question
A single diagnostic test is a one-time cost. Monitoring is not. The American Academy of Pediatrics guideline recommends that clinicians titrate ADHD medication doses to achieve maximum benefit with tolerable side effects [1], which means several dose adjustments and follow-up visits. If you add an objective measure at each step, the number of tests per patient multiplies, and the per-test price starts to matter more than the list price of any system.
Research has used this approach. In one study, 78 children and adolescents taking ADHD medication were tested with a CPT with motion tracking at baseline, one month, and 12 months, alongside an investigator-rated ADHD scale. Both measures showed symptom reductions between baseline and follow-up [2]. For how repeat data informs dose decisions, see using objective data in ADHD medication titration.
Assumptions used in every calculation
- A titration course is five tests: one baseline and four follow-ups. This is an illustrative assumption for budgeting, not a clinical recommendation. Your number may be lower or higher.
- Two panel sizes per year: 10 titration patients (50 tests) and 40 titration patients (200 tests).
- List prices only, accessed September 27, 2026. No tax, shipping, computers, staff time, or negotiated discounts.
- Vendors without public prices (QbTest, MOXO, Creyos) are listed as “not publicly listed” and not estimated.
Cost of one five-test titration course, by platform
| Platform | Price basis (list price on vendor website, accessed Sept 27, 2026) | Five-test course | Arithmetic |
|---|---|---|---|
| AxonCPT, 5-test pack | $49 for 5 tests (axoncpt.com) | $49 | 1 × $49 |
| AxonCPT, 20-test pack | $149 for 20 tests | $37.25 | 5 × ($149 ÷ 20 = $7.45) |
| AxonCPT, free plan | 2 free tests every month | $0 | Up to 2 tests a month |
| Conners CPT 3 Online | $10 per use, minimum purchase 15 (MHS) | $50 | 5 × $10 (first order at least $150) |
| T.O.V.A. 9 | $15 per credit, after $1,095 system (TOVA) | $75 in credits | 5 × $15, system not included |
| IVA-2 (Standard kit) | $119 per 5-test pack (BrainTrain) | $119 tests only; $238 with narrative reports | $119 test pack (+ $119 report pack) |
| QbCheck | From $68 per test (Qbtech) | From $340 | 5 × $68 |
| QbTest, MOXO, Creyos | Not publicly listed | n/a | n/a |
On AxonCPT’s $79/month unlimited plan, and on IVA-2 Deluxe or Premium kits (unlimited test administrations), the marginal cost of one more test is $0 once the subscription or license is paid.
Yearly cost for a titration panel
10 patients, 50 tests a year
| Platform | Year-one list cost | Per test | Arithmetic |
|---|---|---|---|
| AxonCPT packs | $396 | $7.92 | 2 × $149 + 2 × $49 |
| AxonCPT unlimited | $948 | $18.96 | 12 × $79 |
| Conners CPT 3 Online | $500 | $10.00 | 50 × $10 |
| T.O.V.A. 9 | $1,770 | $35.40 | $1,095 (incl. 5 credits) + 45 × $15 |
| IVA-2, tests only | $1,800 | $36.00 | $975 Standard kit (5 tests) + $825 50-test pack |
| IVA-2, tests + reports | $2,625 | $52.50 | $1,800 + $825 50-report pack |
| QbCheck | From $3,400 | From $68 | 50 × $68 |
40 patients, 200 tests a year
| Platform | Year-one list cost | Per test | Arithmetic |
|---|---|---|---|
| AxonCPT unlimited | $948 | $4.74 | 12 × $79 |
| AxonCPT packs | $1,490 | $7.45 | 10 × $149 |
| Conners CPT 3 Online | $2,000 | $10.00 | 200 × $10 |
| IVA-2 Deluxe, tests only | $2,295 | $11.48 | Deluxe kit, unlimited tests (10 reports included) |
| T.O.V.A. 9 | $4,020 | $20.10 | $1,095 + 195 × $15, before bulk discounts |
| IVA-2 Premium, tests + reports | $4,795 | $23.98 | Premium kit, unlimited tests and reports |
| QbCheck | From $13,600 | From $68 | 200 × $68 |
Notes on these figures:
- Hardware systems get cheaper per test with volume. T.O.V.A.’s per-test cost falls from $35.40 to $20.10 as the $1,095 system is spread over more tests, and TOVA offers bulk credit discounts not shown here.
- IVA-2 kits are 3-year licenses, so a year-one figure overstates the annual cost; renewals are $775 (Standard), $1,995 (Deluxe), and $4,195 (Premium). Add $695 if you need the Remote Testing License.
- QbCheck credits are valid for 12 months from purchase. AxonCPT packs don’t expire.
- Break-even on AxonCPT unlimited: $79 ÷ $7.45 per test (20-pack rate) ≈ 10.6. At about 11 or more tests a month, unlimited costs less than buying 20-packs.
Try it with your next patient. AxonCPT gives you 2 free tests every month — no card required. Send a link, your patient finishes in ~16 minutes from home, and you get a norm-referenced report instantly. Create your free account →
Hidden costs of repeat testing
The price table isn’t the whole story for monitoring:
- Where the follow-up happens. If follow-ups are telehealth, an in-clinic test means an extra office visit for each retest. T.O.V.A. is administered on a computer with its USB device, and QbTest is restricted to in-clinic use per Qbtech. Remote-capable options include QbCheck (laptop with webcam), Conners CPT 3 Online (remote administration now available, per MHS), IVA-2 with the $695 remote license, and AxonCPT (phone, tablet, or desktop browser).
- Report fees per retest. MHS’s FAQ says a use is consumed when an Assessment Report is first generated, and that Progress Reports comparing two to four administrations don’t consume a use [3]. IVA-2 sells narrative report packs separately from test packs.
- Practice effects. A 2023 study of open-source attention tasks found practice effects on repeat administration for the CPT [4]. Spacing retests and keeping conditions consistent protects the value of each test you pay for.
Will insurance pay for monitoring tests?
Possibly, but don’t budget on it. APA Services’ billing guide lists monitoring response to intervention among the uses of 96146, the code for a single automated test with an automated result, and also notes that repeat testing not needed for clinical decision making isn’t considered reasonable and necessary [5]. Payer policies vary, and some are restrictive. Our ADHD testing CPT code guide covers code choice. Document why each retest will change management, and verify with each payer.
When another option may fit better
- You titrate young children. T.O.V.A. has a visual test for ages 4 to 5.5 and MHS offers K-CPT 2 for ages 4 to 7.
- You want activity measurement. QbCheck and QbTest track motor activity, which some psychiatrists use when monitoring hyperactivity.
- You already own a T.O.V.A. system or IVA-2 license. Your marginal cost may already be $15 or less per test.
- Your follow-ups are in person and you have a room and staff to proctor. In-clinic products avoid home-environment variability.
- You need a product with FDA 510(k) clearance for institutional reasons. FDA’s database lists QbCheck, QbTest, and T.O.V.A.; AxonCPT is not marketed as an FDA-cleared device.
How this looks in practice
- Baseline before the first dose. Send the patient a test link; they complete it at home in ~16 minutes on their own device, with no app or login.
- Retest after each adjustment, at a similar time of day and interval after the dose.
- Read the trend. Compare omission and commission errors, reaction time, and variability across visits, alongside rating scales and the patient’s report. A CPT doesn’t diagnose ADHD or decide a dose on its own; it adds an objective input.
- Document the decision that each result informed.
To judge whether the output fits your notes, see what the report looks like. For more on remote retesting, read remote CPT testing validity. For single-test pricing across vendors, see what objective ADHD testing costs clinicians. For the clinical-protocol side of the same question — when in the dosing cycle to test — see when to retest: timing a CPT around stimulant dosing.
Frequently asked questions
How many CPTs does a titration course need? There’s no fixed number. We used five (baseline plus four follow-ups) only to make costs comparable. Retest when the result will inform a decision.
Is a subscription or per-test pricing better for monitoring? It depends on volume. With AxonCPT, the arithmetic above puts break-even at about 11 tests a month. For hardware systems, per-test cost falls as volume rises.
Can patients do follow-up tests at home? With remote-capable platforms, yes. Remote testing needs a quiet, standardized setup; our validity guide covers environment controls.
Do prices include reports? It varies. AxonCPT’s site describes an instant report with each test. MHS charges a use when an Assessment Report is first generated. Ask Qbtech how QbCheck reports are handled on your plan. IVA-2 sells report packs separately unless you have the Premium kit.
Start testing your patients with AxonCPT
Repeat testing only works if it’s affordable enough to do at every dose change. AxonCPT publishes its prices: 2 free tests every month, $49 for 5, $149 for 20, or $79 a month unlimited, and patients test from home. Create your free AxonCPT account and run your next baseline, or read more at axoncpt.com.
References
- Wolraich ML, Hagan JF, Allan C, et al. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2019;144(4):e20192528.
- Cedergren K, Östlund S, Åsberg Johnels J, Billstedt E, Johnson M. Monitoring medication response in ADHD: what can continuous performance tests tell us? European Archives of Psychiatry and Clinical Neuroscience. 2022.
- Multi-Health Systems. Conners CPT Online Suite FAQ (PDF) and Meet the Conners CPT Online Suite. Accessed September 27, 2026.
- Langner R, Scharnowski F, Ionta S, et al. Evaluation of the reliability and validity of computerized tests of attention. PLoS One. 2023;18(1):e0281196.
- APA Services. Psychological and Neuropsychological Testing Billing and Coding Guide (PDF). Accessed September 27, 2026.
- Vendor price pages, accessed September 27, 2026: AxonCPT; Qbtech QbCheck; Qbtech QbTest; TOVA store and credits FAQ; MHS storefront; BrainTrain IVA-2 price list.
- U.S. Food and Drug Administration. 510(k) Premarket Notification database. Accessed September 27, 2026.