“Is music therapy reimbursable?” is the question I am asked almost every day! I can sense the feeling of disappointment when I say, “Well, it depends on several things, including how old the client is, what school they attend (if applicable), what state you live in and what types of funding they receive”. Here is the breakdown of what is happening in both Iowa and Illinois in terms of third party funding for music therapy.

IOWA

Currently, there is a program through Medicaid that is called the Consumers Choice Option plan (CCO). This plan sets aside a set amount of money for the client and then allows them to decide how to spend that money. Several people in Iowa are paying for music therapy through this plan. All money goes through an independent financial broker, so the music therapy company does not need to fill out extra paperwork in order to claim these monies.

As for private insurance, we are finding that it depends on the insurance carrier. We have submitted multiple requests to one of the largest insurance providers in the State of Iowa and have been denied every time. We currently have a proposal in front of them that would add music therapy to the list of their covered services. We are still waiting to hear whether or not it will be considered.

In Iowa, schools may often pay for music therapy as part of the student’s IEP related services. It is dependent on the Area Education Agency and the services they already have in place. But it never hurts to ask!

ILLINOIS

In the recent past, the only form of funding for music therapy in the State of Illinois was through private pay or through grant funding. However, several music therapists have been able to capture state reimbursement by obtaining a developmental therapy license. This training requires additional coursework and documented supervision, which can take upwards of 2-3 years to complete depending on availability of classes and supervision. The state funds for developmental therapists are restricted to early intervention which is children ages 0-3.

Within the past several months, the Illinois music therapy task force on reimbursement presented a bill to the State Senate and the State House of Representatives to request a state licensure for music therapists. While this bill is currently tabled, in order to gain more support, music therapists in the State of Illinois are hoping to gain licensure in order to capture state funding for music therapy in the future. By having a license, the State of Illinois would acknowledge the profession of music therapy which will hopefully open more doors in the future.

While the two states are taking different approaches, the hope is that the end result will be the same, third party reimbursement for music therapy! It will happen one day, but looks like it will be at least another year if not two or three before it becomes a reality. We here at West Music are committed to doing our part to further the efforts and we continue to submit requests to insurance companies on behalf of our clients. Our motto is, “They can only say no until they say yes”.

If you have any questions or comments, please email us at musictherapyservices@westmusic.com. Or if you are a music therapist in the state of Iowa or Illinois who has obtained third party reimbursement, we would love to hear your success story!