Rates & Reimbursement

Rates

Initial consultation  FREE 
30-min individual session $33
45-min individual session $40
30-min group session $40
45-min group session $50

Music therapy can be a reimbursable service! Adaire has taken a course on insurance reimbursement, and will do her best to work with clients who qualify to receive reimbursement for music therapy services. Unfortunately, putting in an insurance claim does not guarantee reimbursement. The following are ways that music therapy can be covered, as stated by the American Music Therapy Association:

Medicare

Although music therapy currently does not receive direct reimbursement from Medicare, music therapy services can be included under:

  • 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.

Medicaid Waivers

The state of Minnesota has utilized state and county agency funds and population specific waivers (i.e., autism, developmental disabilities) to cover the provision of music therapy interventions in a variety of settings.

Private Insurance

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.

Other Sources

Additional sources for reimbursement and financing of music therapy services include: many state departments of mental health, state departments of developmental disabilities, state adoption subsidy programs, private auto insurance, employee worker’s compensation, county boards of developmental disabilities, IDEA Part B related services funds, foundations, grants, and private pay.

For a more in-depth reimbursement overview from the American Music Therapy Association, click here: Music Therapy Reimbursement Overview