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Visit These
Helpful Resource Websites:
AIT Institute for Berard Auditory Integration
Training
Detox My Child
Homeopathy for Special Needs Children
(HSNC)
Homeopathy for Women
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Questions to Ask Your Insurance
Company
About Occupational Therapy for Sensory Processing Disorder SPD
SPD Diagnostic Codes
In the current ICD diagnostic manual
there are no recognized procedural codes for or Sensory Processing Disorder
(Sensory Integration Dysfunction, Dysfunction of Sensory Integration.)
Occupational Therapists work with children who have Sensory Processing
Disorder and who have co-existing diagnoses so they may bill for their
services by the other diagnoses.
Many Occupation Therapists are able to
give parents claim forms for Occupational Therapy services.
Sensory Integration therapy is
one of the things that can provided to the child under an OT's license along
with the ability to give insurance claim forms to patients. The child,
however, must be billed with a diagnosis other than Sensory Processing
Disorder or Autism.
Read more
about Insurance Questions for Occupational Therapy.
- Does my insurance plan cover
Occupational Therapy?
- Do I have to get a letter from a licensed medical
provider (Physician or Physician’s Assistant) to state this is medically
necessary?
- Do I need to send the letter from the medical provider
before seeing the Occupational
Therapy provider OR can it be submitted
with the first bill?
- Is a diagnostic code required for reimbursement?
- What is the reimbursement scale for
Occupational Therapy?
- What is the deductible on the plan? $__________ (amount)
- Is there any deductible left to meet this year?
$__________ (amount)
- What is my co-payment per visit? $__________ (amount)
- Is there a limit on the total amount that
can be paid out each year? $__________ (amount)
- Is an Occupational Therapy
Evaluation covered by my
insurance? $__________(amount)
- How many Occupational Therapy
sessions will be covered by
insurance in total per year? $__________(amount)
- Does my coverage extend to the services of a non-network provider?
- What is the maximum covered cost per
Occupational Therapy
session? $__________(amount)
- What is the Co-payment per
Occupational Therapy
session?
$__________(amount)
- Must we be referred for
Occupational Therapy by a medical doctor
or is an OTR sufficient?
- If we are already in
Occupational Therapy
with another provider, what is my remaining coverage for
Occupational Therapy this year? $__________(amount)
- Does my insurance cover the following codes:
- 315.4
coordination disorder
- 728.9 disorder
of muscle ligament/muscle hypotonicity
- 781.3 motor
incoordination
- 781.92 abnormal
posture
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