We hope this page provides answers to the most frequently asked questions (FAQs) we receive about funding for music therapy services at LIH.
Can music therapy service be billed directly to MA?
No. Music therapy cannot be billed directly to MA. Please see the following question about additional programs that may be available.
Do state programs provide funding for music therapy services?
Yes, however, funding is based on state/location and prior authorization/approval.
Many clients and consumers at LIH receive services through state programs such as:
- Children’s Long-Term Support (CLTS) Waiver
- Family Support Program (FSP)
- Family Care (FAMC) (local programs MCOs Inclusa and Care Wisconsin)
- Comprehensive Community Services (CCS) program
In Minnesota, music therapy is an available service through programs such as:
The best place to begin is with the care team of the individual who may be in need of services. ***Please know that enrollment in one of these programs is not a guarantee that music therapy services will be approved or available. LIH is not able to provide services through these state programs without prior approval/authorization.
Are there any grants or scholarships available for music therapy services?
Yes! The Greater La Crosse Region is blessed to have a few different options for community-based grants that have supported individuals in getting started with services.
You can find more information regarding grant application under the RESOURCES tab on our website.
Will LIH submit grants for clients?
LIH is not responsible for completing or submitting a grant request, nor does LIH have any weight in the decision-making process that goes in to determining grant recipients.
Do private health plans cover music therapy?
Sometimes. Insurance coverage for music therapy is significantly dependent on the client’s diagnosis code(s) (ICD-10 codes), procedure code(s) (CPT) billed, and plan restrictions such as in-network/out-of-network providers, etc.
The client may also need to obtain additional supportive materials from a referring medical provider such as a prior authorization or a letter of medical necessity (LMN).
Music therapy is billed just like all other allied health services using a procedure code for the service provided. The code most generally used for music therapy is G0176 which is “Activity Therapy”. Music therapy may also be submitted to insurance for payment using the following procedure/service codes: CPT Codes for Music Therapy.
It is very important to note that codes used by music therapists are often shared with other allied health providers so it is important to know that if services are paid for treatment at LIH, this may limit the number of sessions with another allied health provider.
I contacted my private health insurance plan and I was told that music therapy is not covered. Is this accurate?
Possibly. It may certainly be true if there is no coverage for services that a music therapist would be providing (see CPT Codes for Music Therapy).
We recommend families to contact their private health insurance carrier to ask:
- Is coverage for a specific procedure code/CPT code that will be targeted within the music therapy setting.
- If the insurance plan allows for services to be provided by an individual with the credential MT-BC (Music Therapist Board Certified).
- Be sure the insurance representative is aware of the individual’s ICD-10 (diagnosis) code(s) as this often impacts whether or not a procedure/service code is allowable.
- In addition, it is very important to also ask if there are restrictions on who can provide the service (i.e. credential, in-network/out-of-network, etc.).
I have a Health Savings Account (HSA). Can I use my HSA funds for music therapy?
Yes, depending on your HSA rules/regulations. We have had families successfully submit their receipt/invoice for music therapy services.
Please do let us know if the invoice needs to have specific information included such as LIH’s Employer Identification Number (EIN), the assigned therapist’s National Provider Identification (NPI) number, or service code/procedure code (CPT code). We are happy to assist you with what you need to make the best use of these valuable dollars!
How are services billed at LIH?
Just like when you receive a service such as a haircut, massage, or oil change, a fee for the music therapy session/service is due at the time the session/service was completed/received; however, LIH does offer three different methods to pay (and save)!
- Pre-payment with 10% discount: Because we greatly value clients’ commitment to our services, LIH offers a discount for sessions paid in advance by offering a 10% discount for monthly payment plans and 13% discount for per quarter/semester payment plans. Please contact LIH for current pricing information or visit our online store (soon to come)!
- Payment at time of service: Payment can be made in the form of cash, credit card, or personal check at the time services are provided.
- Invoicing: (pre-authorization required) LIH does invoice/receive payments after the date of service in special, pre-arranged, situations. This is typically reserved for agencies/organizations where the service must be rendered prior to payment of the services. Additional fees may apply if payment is received following the date of service and this was not pre-arranged.