Recreational Therapy

lcohen4

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Do you have or know where I can find information on what medicare covers regarding REcreational Therapy for patients with organic brain disorders, major depressive disorer, etc. patients are elderly - most with form of alzheimrs or dimentia. services by PT and NPP psychotherapist. Example of therapy may be playing dominoes, art or music therapy.

Do these therapies fall under the occupational therapy codes and caps?

or is the the HCPCs G codes?

ANy guidance is greatly apprciated. This is for services in the state of florida.
 

hlmac6483

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Also wondering in NC

Great question! Our MTs have always been part of the IDG for our Hospice patients, but our providers would like to have some of their Palliative Care patients be able to benefit from MT services. Commercial payers might pay, but from what I've been reading, it could require prior authorization to be covered. The HCPCS codes (G0176 & H2032) are not separately priced by Part B, so those wouldn't be covered by Medicare. Coverage may also differ from state to state, and licensure may make a difference also. There are studies out there showing that MT does have a beneficial effect on Alzheimer and dementia patients, but CMS does not seem to have made any moves towards changing their stand regarding the billing for this type of therapy. Perhaps it will change some day.

The attached article might be helpful to you.
 

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