What is music therapy? It is the use of music interventions to accomplish goals within a therapeutic relationship by a licensed professional who has completed an approved music therapy program. Music therapy is used within a therapeutic relationship to help aid in cognitive, physical, emotional and social needs of the party being seen. After being assessed for the needs of the client, the music therapist will provide a treatment which can include singing, creating, moving to and listening to music. This provides avenues for open communication for those who find it difficult to express themselves properly or find the words. Research in therapy involving music supports effectiveness in areas such as rehabilitation, increased in motivation to become more engaged in treatment, emotional support for clients and families and providing an outlet for the individual for expression of feelings.

Who can benefit from music therapy?

All age groups with mental health needs, development disabilities as well as learning, substance abuse, physical disabilities, brain injuries, acute and chronic pain.

Is Music Therapy categorized as a reimbursable service?

Medicaid: There are a few states allowing payment for music therapy through use of Medicaid Home and Community Based Care waivers. Music therapy interventions qualify for coverage under existing treatment categories like rehabilitation, community support or habilitation services.

Medicare: Starting in 1994, music therapy was identified as a reimbursable service under the (PHP) benefits of Partial Hospitalization Programs. It falls under the heading of Activity therapy, interventions must be based on goals specified in the treatment plan. The current HCPCS Code for PHP is G0176. For music therapy to be considered active treatment it needs to meet the following criteria.

-Physician prescribed

-Necessary or reasonable for treatment of individual’s injury and/or illness

-Goal directed and documented in treatment plan

-Goal of treatment cannot be merely to maintain current levels, but to exhibit levels of improvement.

Private Insurance: The American Music Therapy Association has estimated that around 20% of music therapist receive third party reimbursement for the services provided by them. The number of success stories involving third party reimbursements for music therapy continues to grow as more clinicians seek out coverage.