I'd call the national AAP and talk with the folks there. Given the national push for pediatricians to see patients with codes 314.00 and 314.01, your payor is out of sync with the rest of the world. They may be saying "no" just to see if you're interested. You may also see if they pay for any other "mental health" codes, such as depression or anxiety, etc. and/or whether any other specialties are being paid for these codes (eg, internal medicine). Finally, you can send them information that these are now known to be biologically based, neurochemical imbalances and therefore "brain disorders" and considering them "mental disorders" is SO last century. <G> I'm sure the AMA and the Texas Medical Society would also be very interested to learn that they are discriminating against children by not covering this disorder that affects up to 10% of all children. As would the media. Have fun storming the castle! Harry Gewanter, MD Richmond, VA "To know what is right and not to do it is the worst cowardice." -Confucius