Rates vary depending on services being provided. Please call (888) 203-0113 or email Jazmin at firstname.lastname@example.org to inquire about session costs.
Is music therapy a reimbursable service?
Since 1994, music therapy has been identified as a reimbursable service under benefits for Partial Hospitalization Programs (PHP). Falling under the heading of Activity Therapy, the interventions cannot be purely recreational or diversionary in nature and must be individualized and based on goals specified in the treatment plan. The current HCPCS Code for PHP is G0176.
The music therapy must be considered an active treatment by meeting the following criteria:
- Be prescribed by a physician;
- Be reasonable and necessary for the treatment of the individual’s illness or injury;
- Be goal directed and based on a documented treatment plan;
- The goal of treatment cannot be to merely maintain current level of functioning; the individual must exhibit some level of improvement.
There are currently a few states that allow payment for music therapy services through use of Medicaid Home and Community Based Care waivers with certain client groups. In some situations, although music therapy may not be specifically listed within regulatory language, due to functional outcomes achieved, music therapy interventions qualify for coverage under existing treatment categories such as community support, rehabilitation, or habilitation services.
The number of success stories involving third party reimbursement for the provision of music therapy services continues to grow as more clinicians seek this coverage. In response to the increasing demand, the music therapy profession has worked to facilitate the reimbursement process for clients of music therapy services.
The American Music Therapy Association now estimates that approximately 20% of music therapists receive third party reimbursement for the services they provide.
Music therapy is comparable to other allied health professions like occupational therapy and physical therapy in that individual assessments are provided for each client, service must be found reasonable and necessary for the individual’s illness or injury and interventions include a goal-directed documented treatment plan.
Companies like Blue Cross Blue Shield, United Healthcare, Cigna, and Aetna have all paid for music therapy services at some time. Success has occurred on a case-by-case basis when the therapist implements steps within the reimbursement process. Like other therapies, music therapy is reimbursable when services are pre-approved and deemed medically or behaviorally necessary to reach the individual patient’s treatment goals.
We accept cash, checks, ACH and all major credit cards as forms of payment. Payments are due on the 1st of the month for sessions that occur between the 15th-31st of the month. Payments are due the 15th of the month for sessions that occur from the 1st-14th of the month. Please make checks payable to Core3 Harmony & Wellness Services, LLC.
If you are unable to attend a session, please make sure you cancel at least 24 hours beforehand. Otherwise, you will be charged for the full rate of the session.
Any Other Questions
Please contact Jazmin to schedule a session and for any questions you may have. We look forward to hearing from you.