frequently asked questions

• Does my policy cover biofeedback (Code 90901) for my diagnosis of _________ and/or ________? If yes, is it covered under Medical or Psychological Services?

• If it is covered under Medical Services, do I need a prescription or letter from my MD to say that it is medically necessary?

• Since the staff at Sterlingworth Center are out-of-network providers, does my PCP need to refer me for treatment?

The EEG is the only technique capable of revealing a person's brain's state of regulatory activity on a time scale of seconds. The EEG does not indicate one's actual thoughts but does provide information concerning contexts in which thinking occurs (e.g., states of arousal). A predominant feature of the EEG is rhythmic activity. Recent studies in neurosciences indicate that this may be how the brain maintains the continuity of the state. 

A Quantitative EEG evaluation (QEEG) involves sampling brain electrical activity from several (usually 19) electrode sites on the scalp. Obtained data then are submitted to a computer program that quantifies (assigns numeric measures to) many aspects, or features, of the EEG waveforms and compares them to a normative database to determine which, if any, deviate significantly from average for the client’s age. 

While some neuro therapists are willing to proceed immediately with treatment, our policy at Sterlingworth is to wait. Before beginning treatment, we wait until the initial QEEG results are analyzed (This happens with you.) Since results from the QEEG will be used to guide specific aspects of treatment, we feel that proceeding without such guidance would be somewhat similar to a surgeon proceeding to cut without having prior x-ray information.

• NF2 NEUROFEEDBACK (QEEG GUIDED LORETA Z-SCORE NFB)

NF2 expands on the capabilities of traditional neurofeedback with a full range of new advances, bringing to bear the next generation of EEG brain imaging and training tools. In the hands of a good clinician, it is the ultimate brain training toolkit. 

Using a nineteen-sensor cap, the clinician can train any number of areas together (instead of individual surface areas with NF1). By using a medical research database (Z-score) and deep brain source imaging (LoRETA), NF2 can directly train entire brain networks, targeting overall electrical activity (amplitude), brain connectivity (coherence), processing speed (phase), and more. 

This precision training of NF2 makes for a staggering increase in speed and efficacy – results that once took 20 hours of brain training in a dozen half-hour sessions. This is all made possible by more advanced imaging capability – if you can detect it, you can train it. Better imaging equals better results. Better targeting means better reliability. 

For clinicians, seeing precisely what is going on in the entire brain at all times is a real advantage, and by integrating research software, the clinician can map, track, and keep the training entirely up to date. 

NF2 neurofeedback takes more skill and experience to operate, and the equipment required runs at a reasonable twenty times the cost of essential equipment. Hence, sessions usually cost about a third more than traditional neurofeedback – however one needs far fewer sessions to see results. 

Depending on your insurance plan, some companies will cover EEG biofeedback (Neurofeedback) training. At the Sterlingworth Center, we do not bill insurance companies but will provide you with a billing invoice to file if your insurance will cover neurofeedback.

Regarding the interaction of medications (legal or illegal) that a client may be taking, there is a comprehensive agreement in neurofeedback that some medicines can impede treatment progress. In our experience, this has been especially true after several training sessions. In such cases, it is not unusual to have had progressive improvement to a point where progress levels off or even regresses. 

At such times, if the client is on medications (and there have been no new environmental sources of stress which might account for this), it is considered time to have the client or parents consult the prescribing physician regarding the possibility of modifying medication dosages. This is why it is imperative that clients (or their parents) be aware of this possibility and, ideally, discuss it with prescribing physician(s) ahead of time. Otherwise, continuing Neurotherapy after such a point has been reached may be somewhat analogous to trying to “row upstream,” i.e., the medication dosage may be inhibiting further progress.

There is widespread agreement that permanent, adverse side effects very rarely, if ever, occur. Often during training, a client will complain of being tired, which is natural given that “exercising the brain,” as with physical exercise, can be exhausting. Occasionally clients will complain of headaches, dizziness, or “feeling strange” during or following a training session. When the latter occurs, it actually may be a “side effect” of treatment progress; that is, “change” can “feel strange.” All such experiences should be reported immediately to the neuro therapist so they can further explore the severity of the sensation, etc.

However, in practically all cases, such symptoms do not last more than a few hours and do not occur again, especially if the therapist adjusts aspects of the training that may have been their source. This is not meant to imply that there cannot be significant adverse side effects—only that they very rarely are reported. In Dr. Evans’ work with neuro therapists and Neurotherapy over twenty years, he has heard of less than ten reports of persisting severe side effects and has witnessed none.