New NHS payment rules for ADHD and autism assessments (2026/27)

NHS England's 2026/27 payment guidance for ADHD and autism assessment services is final and has applied since 1 April 2026. Published on 26 March 2026 as part of the NHS Payment Scheme, it introduces the first national currency model for ADHD and autism services. It also sets guide prices that are not compulsory. Since NHS England uprated them for pay awards in August 2026, they are £860 for an adult face-to-face ADHD assessment and £1,163 for adult autism. Providers are paid only once the pathway is complete, and must send data to national data sets. From April 2027, NHS England intends to bring in new payment arrangements after a consultation on national prices.

Key takeaways#

• Commissioners will start rate negotiations from the guide prices, so know your own cost per assessment.
• You invoice only after the outcome report reaches the referrer. Patients who drop out before then bring in nothing.
• Poor MHSDS or CSDS data can hold up payment, and NHS England will publish provider-level data.

1. The 2026/27 ADHD and autism payment guidance has applied since 1 April 2026#

The 2026/27 NHS Payment Scheme sets the rules for how NHS-funded care in England is paid for from 1 April 2026 until the next scheme takes effect (expected 1 April 2027). For the first time, it includes its own supporting document for neurodevelopmental services: the ADHD and autism diagnostic assessment services payment guidance.

Many pages online still quote the draft or March prices#

Many pages online still quote the draft prices, or the March prices from before the August uprating. NHS England opened a formal consultation on 17 November 2025, closing 16 December 2025. It received a very large number of responses on the ADHD and autism proposals. The final scheme, published 26 March 2026, raised every headline assessment guide price from the draft. In August 2026 NHS England uprated the prices again for 2026/27 pay awards, but did not reissue the ADHD and autism guidance document, which still shows the March figures.

Before this, commissioners paid very different amounts with no national price#

NHS England's stated reason is that there was no national service specification and no national price for these services before. Commissioners paid very different amounts and knew little about what the services cost to run. The guidance sits alongside the ADHD Taskforce final report (November 2025) and the 2023 national framework for autism assessment services, which we explain in full separately.

This is a first version, and new payment arrangements are planned from April 2027#

NHS England calls this a first version, and says the data providers submit is essential to how future payment models are developed. In March 2026 NHS England called national guidance for these services and a possible payment method longer-term goals. Since then, the price part has moved faster (see below).

Prices have already changed once. In August 2026 NHS England raised the scheme's cost uplift factor from 2.03% to 3.24% to reflect pay awards and the resident doctors' deal, and reissued every price, backdated to 1 April 2026. After the Fonagy review, the government said on 9 October 2026 that NHS England will consult on national prices for NHS-funded ADHD and autism services, covering assessment, post-diagnostic support and follow-ups. NHS England intends to bring in finalised new payment arrangements from April 2027. When we checked on 5 November 2026, that consultation had not been published. Our summary of the Fonagy review for providers covers the price consultation behind them.

From consultation to in force, and what comes next17 Nov 2025Formal consultation opensNov 2025At least nine ICBs pause RTC referrals16 Dec 2025Consultation closes26 Mar 2026Final scheme published1 Apr 2026Guidance in forceAug 2026Prices uprated for pay awards, backdated to 1 April9 Oct 2026Government says NHS England will consult on national pricesApr 2027New payment arrangements intended17 Nov 2025Formal consultation opensNov 2025At least nine ICBs pause RTC referrals16 Dec 2025Consultation closes26 Mar 2026Final scheme published1 Apr 2026Guidance in forceAug 2026Prices uprated for pay awards, backdated to 1 April9 Oct 2026Government says NHS England will consult on national pricesApr 2027New payment arrangements intendedEvery date also appears in the running text. The price consultation had not been published when we checked on 5 November 2026.Key dates from the opening of the consultation to the new payment arrangements planned for April 2027.

2. The ADHD currency model prices an assessment as a bundle of tasks#

A currency, in NHS payment terms, is a standard unit of care that can be counted and priced. The 2026/27 scheme brings in a first version of a currency model for ADHD and autism services. It feeds into wider NHS work on community currencies and mental health resource groups. "An assessment" is now a set bundle of tasks rather than a single appointment.

Each bundle covers the pathway from triage to post-assessment work#

• Adult ADHD assessment. The currency includes triage of the referral, signposting, admin, liaison with other partners, the diagnostic assessment and outcome report, psychoeducation, relevant follow-up, discharge, and following up patients who missed appointments (DNAs).
• CYP ADHD assessment. The CYP version also includes cognitive assessment, reading screening tools, liaison with school and other professionals, and promoting local and national resources, but does not list psychoeducation or follow-up.
• Autism assessment. The autism currencies cover finding and referring patients, screening and triage, pre-assessment support, the assessment and diagnostic outcome, and post-assessment support.

What the adult and children's ADHD assessment prices each coverAdult£860£708 virtualCYP£961face to faceIn bothTriage of the referralIncluded for adultsIncluded for children and young peopleAdminIncluded for adultsIncluded for children and young peopleSignpostingCYP adds referral to other agenciesIncluded for adultsIncluded for children and young peopleLiaisonAdult: other partners. CYP: school and other professionalsIncluded for adultsIncluded for children and young peopleDiagnostic assessment and outcome reportIncluded for adultsIncluded for children and young peopleDischargeIncluded for adultsIncluded for children and young peopleRe-engaging missed appointments (DNAs)Included for adultsIncluded for children and young peopleAdult onlyPsychoeducationIncluded for adultsNot listed for children and young peopleFollow-up the service judges is neededIncluded for adultsNot listed for children and young peopleChildren and young people onlyCognitive assessmentNot listed for adultsIncluded for children and young peopleReading screening toolsNot listed for adultsIncluded for children and young peoplePromoting local and national resourcesNot listed for adultsIncluded for children and young peopleFrom the activity lists in the 2026/27 payment guidance. Each price pays for the whole list, not per appointment. There is no national price for a virtual CYP assessment. The clinician carries out the clinical assessment and makes the decisions.What each ADHD assessment price covers, from the activity lists in the 2026/27 payment guidance.

Pathways should fund pre-diagnosis work, including a recorded change to surroundings#

The pathways commissioners pay for should include, and fund, work before diagnosis. That includes at least one recorded change to the person's surroundings before medication is considered, in line with NICE, and it will show up in activity reporting. Diagnosis must be made by a suitably qualified professional, and autism assessment should involve a multi-disciplinary team. If your service skips a part of the bundle, the currency definition now makes that easy to see.

3. NHS guide prices for 2026/27, not mandatory: £860 adult ADHD face-to-face, £1,163 adult autism#

The guide prices are not mandatory. NHS England describes them as benchmarks "intended to be interpreted considering local context, delivery models, and existing relationships". They are averages built on a caseload with a mix of simple and complex cases, so ICBs may need to change them where a provider's caseload is not mixed. There is still no mandatory national standard price for an autism assessment; £1,163 is a guide, not a set price.

The prices in force are the ones NHS England reissued in August 2026 to reflect pay awards, backdated to 1 April 2026, in Annex A of the scheme (tab 8). The ADHD and autism guidance document was not reissued, so it still shows the March figures, listed here for comparison. Whenever a price is used, the scheme says the local market forces factor (MFF) should be applied to reach the final price.

Every assessment guide price rose between the draft and the final scheme#

Every assessment price rose between draft and final, according to NHS England's consultation change log. In the March scheme, adult ADHD face-to-face went from £800 to £850, adult virtual from £600 to £700, adult autism from £950 to £1,150, and CYP autism from £950 to £1,350, a £400 increase. The August uprating then added just over 1% to each. The change log also notes the titration price was based on an average of three titration appointments, with room to flex for complex cases.

Every assessment price rose after consultation, autism mostAssessmentDraftNowRiseAdult ADHD, face to face£800£860+8%Adult ADHD, virtual£600£708+18%Adult autism, face to face£950£1,163+22%CYP autism, face to face£950£1,366+44%NHS guide prices (not compulsory), not Cerebric prices. The final scheme in March set £850, £700, £1,150 and £1,350; the August 2026 pay award added about 1%. Sources: NHS England consultation change log and Annex A prices workbook v2.Draft and current NHS guide prices, which are not compulsory (not Cerebric prices), for the four headline assessments.

Virtual CYP ADHD, virtual autism and virtual combined assessments have no guide price#

Virtual CYP ADHD, virtual autism and virtual combined ADHD/autism assessments have no national guide price. Commissioners should keep paying for virtual CYP ADHD assessments where they already exist, at a locally agreed price. For virtual autism and combined assessments, they should agree a local price, and providers of virtual-only autism services should have quality and safety checks.

4. Providers invoice assessments only on completion; earlier drop-outs earn nothing#

Payment is tied to completing the pathway, so completion rate matters to finance as well as to clinical quality:

An assessment is paid only when the outcome report reaches the referrerReferralScreeningAssessmentReport sent to the referrerPatient leaves anywhere here: no paymentInvoice payablethe full priceADHD assessments can also be invoiced when the patient moves to the medication stage. Titration and reviews have their own triggers, in the table above. DNA penalties should not be used.When an assessment becomes payable under the 2026/27 guidance. Titration and reviews are in the table above.

Two further rules matter here.

DNA penalties should not be used; the price covers missed appointments#

DNA penalties should not be used in ADHD and autism assessment contracts. Missed appointments count as covered by the assessment price, and following up DNAs is part of the currency bundle. If no-shows are taking up your capacity, the cost is now yours to manage; we cover the cost of missed appointments (DNAs) in ADHD and autism clinics separately.

The £268 adult annual fee without shared care needs four strict conditions#

The adult annual fee without shared care can only be charged when all four of these conditions are met:

• The patient is stable on medication after titration, and you have sent the GP a shared care letter.
• The GP refuses, or does not reply within 21 days.
• You are willing to keep the patient in your medication pathway.
• Prescriptions are Y-code prescriptions for patients within the ICB.

The fee becomes payable on the date the last of the four is met.

5. Right to Choose providers face rate pressure but should see fewer repeat assessments#

From November 2025, at least nine ICB areas paused Right to Choose (RTC) referrals for ADHD and autism assessments after assessment budgets ran out less than eight months into the financial year. We cover what providers can do during Right to Choose referral pauses separately. Three parts of the guidance matter most for RTC and framework providers.

Guide prices will be the starting point for every rate negotiation#

If your RTC or framework rate sits above the benchmark, expect commissioners to push towards it. If your cost per assessment sits above it, you have a margin problem to fix before contract renewal. Our analysis of ADHD and autism assessment margins compares private fees with the guide prices.

NHS titration services should accept independent diagnoses#

The guidance says ADHD and autism diagnostic reports from independent providers, including RTC providers by name, should be accepted by NHS-commissioned titration services unless there is a clear clinical reason not to. That should cut the repeat assessments that independent-sector diagnoses have often faced.

Regular non-contract activity should move to a written contract#

Rules on non-contract activity (work done without a local contract) are getting clearer. A provider holding a qualifying contract with a single ICB can serve patients from any ICB, but NHS England is clear that regular, ongoing work should move to a formal written contract. See our guide to becoming an NHS Right to Choose provider.

Systems should avoid private prescriptions and tell patients what each service offers#

The guidance also asks systems to avoid private prescriptions in NHS-funded pathways. It says what each service offers must be explained to patients through their GP practice at the point of referral, so GPs can explain exactly what each provider's pathway covers.

6. MHSDS or CSDS data submission is mandatory, and poor data can hold up payment#

All providers of NHS-funded ADHD and autism diagnostic assessment services must submit to the appropriate national data set under the NHS Standard Contract. That is the Mental Health Services Data Set (MHSDS) for mental health settings, or the Community Services Data Set (CSDS) for community settings. The required data covers referral information, assessment outcomes, diagnosis details, care contacts, and discharge and onward referrals.

Two things enforce it.

NHS England will publish the data at provider level#

NHS England will publish the data it currently holds at provider level, with the aim of pushing providers to improve what they submit. The Fonagy review goes further: it wants referrals, wait times and outcomes reported separately for NHS-funded and private patients, as a condition of funding.

Commissioners are advised to pay only when data and invoicing standards are met#

Commissioners are advised to approve payment only when providers meet the required data and invoicing standards, with ICBs tracking compliance at regular provider meetings. Invoices must follow Service Condition 36 of the NHS Standard Contract, and commissioners are under no obligation to pay for activity invoiced outside its time limits.

A provider that assesses well but submits poor data may find payment held back.

7. Five steps prepare your service for the 2026/27 payment rules#

1. Know your cost per currency unit. Work out your full cost, overheads included, for each currency (adult ADHD assessment, titration episode, annual review) and compare it with the guide price in force after your local market forces factor. Include clinician time, admin, informant chasing and report writing.
2. Report by payer type. Private, RTC and NHS contract work carry different rates, data duties and payment triggers. Without volumes and margins split by payer, it is harder to negotiate rates.
3. Get MHSDS/CSDS submissions right. NHS England plans to publish provider-level data, and commissioners are advised to tie payment to data standards. Decide now who owns it.
4. Track completion as well as bookings. Measure drop-out between referral, screening, assessment and report, and fix the step that loses the most patients first.
5. Show your capacity. With activity management plans pausing referrals mid-year, commissioners will ask what you can deliver and prove. Data on waiting times and completed assessments helps in framework negotiations.

Where Cerebric fits#

Cerebric, a UK platform for neurodevelopmental assessment services, reports activity by payer type (Private, Right to Choose and Contract) with CSV export for NHS submissions. Because the price now covers missed appointments, it also tracks DNAs and shows each patient's DNA history when they are booked. Clinics using Cerebric saw an 87% drop in staff time spent on screening.* Book a consultation to see how it works for your service.

Measured at UK Right to Choose and private neurodevelopmental providers using Cerebric, 2025–26.