How much do you spend on OT (out-of-pocket/network)?

[Anonymous]

We would like to explore OT, for gross motor movements, before our DC starts kindergarten in the fall. Having an impossible time getting returned calls from the in-network occupational therapist nearby. Also having tough time getting specific details on cost from recommended out of network docs. what should I expect to pay out of pocket per visit?

[Anonymous]

Where do you live and what insurance do you have? We went back to OT when I finally found an in-network provider

[Anonymous]

PP here again Also I will say that if this is for gross motor then that's PT and that is easier to get in network than OT It's considered much more "medical"

[Anonymous]

We are paying out of pocket $60/half for OT for someone to come to the house (this person has a full-time OT position at a school, so extra income for him). I found when calling around to centers that an evaluation was like $350 and a similar hourly rate. I plan to submit to our insurance, fight, and have them pay nothing. (Fine motor)

[Anonymous]

OP here. We are in Bethesda (but closer to rockville and Potomac than DC). Willing to travel a bit within MoCo or NW DC, particularly if we could find someone in network (and they have evening or wknd hrs). We have a BCBS PPO. Insurance company says they cover 70% of their approved fee (which could be less than provider rates apparently). I imagine it depends on the provider and severity of the child’s issues. But I was just trying to gauge if when families pay OOP what that looks like, as our resources are not infinite.

[Anonymous]

I would expect anywhere from $60-$80 for 30 mins of OT. If you're going out of network, ask them to prepare a super bill for you so that you can submit to your insurance for reimbursement for hopefully some portion of it - as it pertains to your "out of network benefits".

It took me a while to figure this one out, and therefore most likely walked away from a lot of reimbursed expenses because i didn't know you could do this.

[Anonymous]

OP here again. Thank you for the responses. I finally got in touch w/ an OT provider billing office willing to walk me through their billing codes and costs,and circled back w/ my insurance company to get their reimbursement rates. After speaking to a second person at BCBS she said they could reimburse the provider directly which would be nice.

My last and final question: how often (weekly, monthly) does you take your kids to regular OT therapy sessions? Again, I realize this likely varies on the child and their needs. However, I'm trying to get a sense of what is "standard" for both costs and time commitment, as the office we found is only open M-F/9-6pm. So trying to get a sense of how often our kid would have to miss preschool and we'd be taking off of work on a monthly basis for appointments (since DH and I work downtown and don't have a nanny or caregiver).

Thanks again for all of your help as I try to figure out the lay of the land. This is all very new to our family!

[Anonymous]

Anonymous wrote:OP here again. Thank you for the responses. I finally got in touch w/ an OT provider billing office willing to walk me through their billing codes and costs,and circled back w/ my insurance company to get their reimbursement rates. After speaking to a second person at BCBS she said they could reimburse the provider directly which would be nice.

My last and final question: how often (weekly, monthly) does you take your kids to regular OT therapy sessions? Again, I realize this likely varies on the child and their needs. However, I'm trying to get a sense of what is "standard" for both costs and time commitment, as the office we found is only open M-F/9-6pm. So trying to get a sense of how often our kid would have to miss preschool and we'd be taking off of work on a monthly basis for appointments (since DH and I work downtown and don't have a nanny or caregiver).

Thanks again for all of your help as I try to figure out the lay of the land. This is all very new to our family!

Typical frequency is once per week. That's how the providers' schedule and you really need this level of therapy to see benefits. In addition, the therapist should give you 'homework' to do with your child daily.

[Anonymous]

We have Kaiser Permanente. My son has OT twice per week (30 minute sessions) with a $10 co pay for each. However, without an ASD diagnosis they would not cover any OT, Speech or ABA.

[Anonymous]

OT is for fine motor. You need a PT. Early Intervention Associates accepts many insurances for PT. I don't know if they have Saturday hours but the do have very early hours.