Insurance | Outpatient Recreational Therapy (RT) in Austin, Texas

We Love Insurance Companies, But They Don't Love Us!
So, No Insurance Accepted for Payment.
We Provide Direct Billed Services via a Monthly Subscription.

We Accept Direct Payment via a monthly subscription (debit, credit card, bank transfer) from clients.
Our specialized outpatient Recreational Therapy services are direct billed to our clients and are NOT covered by Medicaid, Medicare or most insurers.
Inpatient Recreational Therapy services (when patients are in the hospital, residential treatment center, etc.) are covered by many insurers. We are working with professional organizations to expand the inpatient coverage to outpatient services.
Recreational Therapy doesn't stop helping people when they are discharged from the hospital.
We do NOT process any insurance eligibility. There are over 1,000 health insurance companies in the United States and they all have specific policies as to what they will cover. We do not have the medical billing staffing resources to address these issues.
Please check with your insurance provider to determine if they will reimburse you for our services.
Upon request, we will provide clients with a Superbill to submit to their insurance company.
SEE FAQ's BELOW: We are accepted by limited third-party payers for Veterans and Pediatric (SSES, YES Waiver, etc.) clients.

FAQs: Third-Party Payers

VETERANS SERVICES

Veterans Benefits - If you obtain approval for our Outpatient Recreational Therapy services (covered through the Community Care Network or any other program), we will accept those letter of authorization benefits for payment for our services. Share with your VA health care team that, "The community provider you want to go to isn’t in our network." TRICARE appears to only cover Recreational Therapy as an ancillary therapy for inpatient treatment.

CLASS

"CLASS provides home and community-based services to individuals with related conditions as a cost-effective alternative to an intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID). [...] Those interested in receiving CLASS are placed on an interest list by calling 877- 438-5658 and asking for the CLASS Waiver Program. The person will be contacted when funding becomes available. [...] For more information please contact CLASSPolicy@HHSC.state.tx.us [.]"

PEDIATRIC SERVICES - SSES

The Texas Education Agency provides grants for some children. We are an authorized provider.

PEDIATRIC SERVICES - YES WAIVER

We have provided pediatric RT services (in central Texas counties of Bastrop, Burnet, Travis and Williamson) through

the Youth Empowerment Services (YES) Waiver program (a 1915(c) Medicaid program).

This program is administered by a Local Mental Health Authority (LMHA) or Local Behavioral Health Authority (LBHA).

Find your LMHA here.

PEDIATRIC SERVICES - INTEGRAL CARE (Travis County)

Our Clinical Director is a provider in Travis county, Texas with Integral Care and has delivered pediatric RT services with several of their programs including Communities in Schools (CIS) - Central Texas and Juvenile Justice.

PEDIATRIC SERVICES - IDEA and 504

Recreational Therapy is a "related service" under the federal law Individuals with Disabilities Education Act (IDEA). Part C of IDEA also covers Early Intervention services. In Texas, we have previously provided Pediatric RT services via EANES ISD.

"The U.S. Department of Education enforces Section 504 of the Rehabilitation Act of 1973, as amended, (Section 504) a civil rights statute which prohibits discrimination against individuals with disabilities. The Office for Civil Rights (OCR) also enforces Title II of the Americans with Disabilities Act of 1990 (Title II), which extends this prohibition against discrimination to the full range of state and local government services, programs, and activities (including public schools) regardless of whether they receive any Federal financial assistance." In Texas, here is a Section 504 Fact Sheet.