 | With Health Insurance: Copays + 10%-50% Coinsurance |
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 | Without Health Insurance: $50-$400 Per Hour |
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| Occupational therapy typically involves working with a patient and tailoring the environment to help patients with physical, mental or emotional disabilities to perform daily tasks at home or work. Occupational therapy can be used for patients with a wide range of conditions and problems, including serious injury, learning or developmental disabilities, recovery from strokes and heart attacks, surgery, cancer, mental health issues and arthritis. | | |
| Typical costs: | - Occupational therapy typically is covered by health insurance in certain cases. For example, Aetna considers short-term occupational therapy medically necessary to help regain daily living functions lost as a result of an injury or illness, but typically does not cover it when the primary diagnosis is mental retardation or developmental delay. Some policies limit the total number of sessions. For patients covered by health insurance, typical out-of-pocket costs consist of coinsurance of 10%-50% and copays for any required medical devices.
- For patients not covered by health insurance, occupational therapy typically costs about $150 -$200 for an initial evaluation, then $50 -$400 per hour, depending on the type of service and the provider; costs tend to be on the higher end through a hospital. For example, One on One, a provider in Texas who does not bill insurance directly, charges $50 an hour, with a 25-cent per-mile surcharge for trips of more than 12 miles. Garden City Hospital in Michigan charges $100 per session. ECS Therapy in Pennsylvania charges $200 for an initial evaluation, then $65 for a half-hour session -- or $130 an hour. Akron General Hospital in Ohio charges $170 for an initial evaluation, then $50 -$100 per 15 minutes -- or $200 -$400 per hour -- depending on the type of therapy performed.
What should be included: | - The occupational therapist typically will meet with a patient for an initial assessment and to formulate a therapy plan. Therapy sessions typically are tailored to the individual case and can include work on skills ranging from getting dressed to driving, exercises to improve strength and flexibility, recommendations on adjustments to home and work environments to accommodate the individual, and help learning to use any necessary assistive or medical devices.
- WebMD has an overview of occupational therapy.
Additional costs: | |
Discounts: | - Some clinics offer occupational therapy. The U.S. Department of Health and Human Services offers a locator for clinics that provide discounts on an income-based sliding scale.
Shopping for occupational therapy: | - A primary care physician or specialist can provide a referral to an occupational therapist.
- Occupational therapy is regulated at a state level. The National Board for Certification in Occupational Therapy provides a state-by-state list of regulatory bodies that oversee occupational therapy. It is important to make sure an occupational therapist is credentialed by the proper state regulatory agency. At a minimum, an occupational therapist should have a master's degree from a school accredited by the Accreditation Council for Occupational Therapy Education. In addition, occupational therapists can choose to become certified, and consumers can contact the National Board for Certification in Occupational Therapy to verify certification.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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Article updated September 2011 |
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