Has anyone had any luck getting insurance coverage for PACE or any of the other Cognitive Therapies. I’m betting I can get my son’s neurologist to write a scrip. and memo stating that is medically beneficial. Our OT has been covered. And I was able to get FastForward covered by submitting the therapy as weekly sessions versus 1 lump fee for the program. We paid our copay for each session and the Sci.Learn fee, but it helped a lot.
PACE might be harder to push through, since it could be interpreted as “an educational service” versus a therapy. Also, our PACE provider has a teaching background and works from her home. But, it never hurts to ask.
Rosie
Re: How did that work for FFW?
We did FFW in the speech therapist office. She billed us for 2 or 3 sessions a week. It was several years back so I can’t remember. My son worked the program for 13 weeks in hopes to raise some of his scores that lagged behind. We paid co-pays for those sessions. The entire cost of the program was not covered, but a significant portion. We started StepForward at the office for the first week and a half, then moved it to our home. Since we were the first in their office to go through the program she gave us a break on the price and invoiced us for the first 8 sessions in the office. It helped. Although, after reading one of your posts Mary, I probably could have gotten myself approved as a site and saved even more money.
We’ve decided to do PACE. Our provider said that 2 of her clients were able to get some insurance coverage. I am going to try. Our son’s neurologist recommended Cognitive Therapy, although he referred my to a speech therapist who does Cognitive Therapy. I am going to get our doctor some information about PACE and ask him to write a short letter stating that the PACE program would be medically “beneficial” for my son. We’ll see if it works. I also going to try and find our how those other clients were able to do it. I’m hoping there are other folks outs there who have tried this too. I will help our case.
Since FFW requires training 5 days a week, I am wondering if your son then trained at home? And your FFW provider just billed you weekly for her services? Very interesting idea!
I have yet to hear of an insurance company covering PACE, but that doesn’t mean it couldn’t be. My neighbor was just wondering if she could get NAET treatments for her son’s allergies covered (in that case, probably through a chiropractor’s office, though, which would already have experience with submitting claims to insurance companies). What we have both heard is that everything depends upon how a treatment is coded. There may be a way to code PACE so that it falls into a category that is covered. There must be people who specialize in insurance codes, but I’m not sure how to find them.
Mary