Paying for Therapy

Creative Beginnings OT is not paneled with any insurance companies.

Out of Network benefits and Superbills

If you have insurance, see if it covers “out of network” (OON) Occupational Therapy. Out of network (OON) refers to healthcare providers that do not have a contractual agreement with a particular health insurance plan. When you receive services from an out-of-network provider, you must pay for therapy first, then seek reimbursement. Creative Beginnings OT provides Superbills. Superbills are monthly receipts detailing what therapy sessions you’ve already paid for. The superbill can be submitted to your insurance carrier for reimbursement. Your insurance may cover a portion or all of the costs. All plans are different. To check, call the number on the back of your insurance card.

Creative Beginnings OT requests you leave a card on file for easy auto payment when you build a client profile. You can pay with your health savings account (HSA) or flexible spending account (FSA). Place this card on file as your preferred payment method. These cards are not to be used for missed appointment/no-show fees.

Is a physician referral required to start OT?

A physician’s referral/order/prescription is recommended for insurance reasons prior to receiving an OT evaluation.

For cash pay clients, a referral is not required to start OT services. However, if you plan to submit your invoice for out-of-network coverage, check with your insurance to learn if a physician referral and/or certain diagnosis codes are needed for reimbursement.

Under the No Surprises Act, practitioners must provide an estimate of treatment costs.

Creative Beginnings OT makes many attempts through our initial intake questionnaire, website, payment policies, cost listed while booking an appointment and no surprises act documents in the client’s profile to disclose to the financially responsible party the charges per session.

Details of Services and Items for Creative Beginnings OT, PLLC might include:

Occupational Therapy Evaluation: CPT97166 or 97167 - $600. Evaluations include intake documentation along with an approx. 55-minute evaluation to compile a comprehensive multi-page report. In most cases, the evaluation includes a sensory profile. Treatment planning, billing, and documentation are completed outside of this time block.

Occupational Therapy Treatment Codes could include: Therapeutic Activities (CPT-97530), Sensory Integration Techniques (97533), Therapeutic exercise (97110), Self-care (97535), community training (97537), caregiver training (97550, 97551). A 40-minute treatment session = QTY 3 units = $210. If you want a general estimate, multiply the number of weeks per year you intend to pay for therapy times the $210 rate. Treatment pre-planning, documentation of session, and billing occur outside of this time.

Additional health care provider/facility notes: In some cases, for established clients, home visits, school observation visits and increased length of appointment may be applicable. Prices depend on the services and are disclosed with the guardians before booking.

Depending on home program follow-through, family input, and the child's progression, the client may need between 10-70 sessions this year. The frequency your child receives occupational therapy is at the discretion of the caregivers and per the payment policy: payment is private pay with superbills. Reimbursement from the insurance company is at the discretion of your insurance and your specific plan.

What is the client portal?

The client portal is your effective way to manage you or your child’s care.

• Schedule your appointments

• Secure message with your practitioner

• Download superbills

• Review policies.

• Complete intakes.

• Review patient treatment notes for home program materials.

Registration does not add you to an email list and we never share information.

How to a register a minor to the client portal?

For the adult guardian of an 11 & Under child minor, accounts can be created in the minor’s name.

For the adult guardian of a 12-18 year old adolescent minor, we are legally required to create separate access for the adolescent minor to access their health information. Please create an account in the portal in the child’s name (using the child’s preferred email) and we will manually link you to your teen (with your adult preferred email).