Is Art Therapy Covered by Insurance? An Austin, TX Art Therapist Explains
Gone are the days when art therapy was regarded as a fringe-y hobby (“make art and forget your blues”) or a subservient adjunct to professional mental health treatment (“art therapy isn’t real therapy”).
Art therapy has gained a lot of ground in the last several decades and can stand shoulder-to-shoulder with other mainstream, master’s level mental health professions like counseling, marriage & family therapy, and social work.
An art therapist in Austin, TX has earned a graduate degree, obtained post-graduate supervision, passed post-graduate competency exams, and engages in continuing education to ensure ongoing familiarity with current trends in mental health practice, law, and ethics.
All these things signify the robust presence of standards that have been developed to protect the public.
Art Therapy is More Recognized Than It’s Ever Been
Now that the profession of art therapy has achieved the establishment of art therapy licensure in 15 states and the District of Columbia, the public is more aware of art therapy than it has ever been. And people like you are wondering if art therapy services, rendered by someone who is legally able to call themselves an art therapist in Austin, TX, are covered by insurance companies.
The answer to that question is a little nuanced and depends on where you live. So here goes! I’ll try to explain.
What Are Healthcare Decisions Based On?
Historically, the birth of managed care in the United States really changed the healthcare landscape and made insurance companies the powerhouses they are today. Managed care came along in the 1980s and very quickly ate up the healthcare scene, making it more reliant upon insurance company business decisions than upon healthcare provider knowledge and skills.
This means that decisions about your care aren’t necessarily based on what’s best for you. Instead, they are often based on what’s within the best interest of the insurance company.
Insurance Companies Set the Standards
This has been the law of the land for the past many decades, but on the plus side, insurance has made healthcare affordable for many people. Did you know that in the 1930s most people didn’t have healthcare insurance—it was peddled by door-to-door salespeople?
If people were sick, they paid out of pocket for what they needed. Granted, medical advances back then weren’t what they are now. As of this writing, I have a loved one in the hospital with all sorts of things wrong in his 84-year-old body, but if this were 100 years ago, he probably wouldn’t have lived this long.
Our advances have prolonged our lives and expanded our expenses.
The Quality of Healthcare Coverage Varies Geographically
The U.S. has geographical pockets where medical insurance can get you top-notch services, and fortunately my loved one lives in one of those places. Then there are geographical pockets where medical insurance can get you lamentable services.
Complaints to ombudspeople fall on deaf ears. People often travel 90 minutes just to seek better healthcare. If only insurance covered mileage driven.
Health Insurance Should Prioritize Your Needs and Provider Expertise
But it doesn’t. Insurance companies seek to maximize profit and minimize expense. This takes us back to the problem of healthcare decisions that don’t factor in your needs or your provider’s expertise. The bottom line is that insurance companies have us where they want us.
Health Insurance Has a Dark Side
Insurance reimbursement to providers is what drives many competent practitioners out of business or forces them to join the ranks of corporate healthcare enterprises. Because insurance companies try to keep reimbursement low (remember, they’re on a mission to maximize profit), even the corporate healthcare enterprises are understaffed and consistently asked to do more with less.
This explains why mistakes happen, such as phone calls that don’t get returned and test findings that don’t get communicated. Medical records you’ve authorized to be shared between doctors offices aren’t shared, and other people’s lab results do get shared with you—only they are presented as your results.
This is what insurance is doing for us.
Health Insurance Companies Prioritize Profit Over Your Treatment
To add to this, insurance-based mental healthcare is about to take a turn for the worse. Insurers are now armed with AI predictive models that will soon force providers to choose between their clinical judgment and their ability to make a living.
Please don’t take my word for it; the fight is on, and it only takes a little digging around on the internet to find credible sources that are advocating for the public’s emotional-behavioral best interest, not insurance profit.
It is expected that insurance-based mental healthcare will quickly look like a short-term model that favors the treatment of superficial issues. But what if your issues run deeper?
Insurance Coverage for Art Therapy is Complicated
If you want to use health insurance for mental health and wellness purposes, by all means, go ahead. You are an insured, and you’re supposed to receive benefits, right? You may discover that your benefits aren’t all that beneficial, but you really won’t know if you don’t try.
Just understand that changes are already on the way. As for whether art therapy in Austin, TX is covered by insurance, let’s loop back to that question. The answer is not a clear yes or no; it generally depends on several factors: the medical necessity of art therapy services for your condition, your particular insurance plan and policy, the terms associated with a provider’s art therapy license, and other mental health credentials the art therapist has obtained.
Let’s take a look.
Is Art Therapy Medically Necessary for Treating Your Struggles and Symptoms?
If your insurance coverage is going to be invoked, no matter WHAT service is being provided, there has to be something called “medical necessity” to justify your receipt of that service. At the top of every healthcare provider’s medical note that documents the service you’ve received, there’s a box called “Chief Complaints” for justifying medical necessity.
This box gets filled out with information from you (the struggles and symptoms you’re experiencing) as reported to the healthcare provider. This “Chief Complaints” box (a very negative way to frame things, in my opinion) is used by your insurance company to determine whether you had a medical need for the service you were seeking.
Insurance Companies Focus on ‘Chief Complaints’
This makes sense from the insurance company’s standpoint. Aside from this rather obvious focus on illness instead of wellness, medical necessity is mandatory if insurance if going to be asked to cover a service like art therapy in Austin, TX.
You may be able to obtain a physician’s order or referral for art therapy, which would imply that a medical professional thinks the service is medically necessary.
What Does Your Insurance Policy Say About Covering Art Therapy Services?
Some insurance plans may cover art therapy in Austin, TX. Search through the insurance materials you were sent at the beginning of your coverage period or go online to your insurance company’s website to find this information.
Yes, it will take work on your part. But it’s your life, and no one can live it for you. Just finding what you’re looking for can take a lot of time, but you will be more informed about your coverage and thus more empowered to make healthcare decisions that benefit you.
Be aware that there may be certain conditions under which your insurance plan covers art therapy and certain conditions under which it doesn’t. This could vary in terms of the art therapy provider’s credentials (see the next two sections below) or whether the art therapy treatment setting is inpatient vs. outpatient.
Get Documentation of Your Coverage for Art Therapy in Austin, TX
I would strongly suggest that you obtain proof of coverage in writing. Why? Because if you merely talk to an insurance rep on the phone, you’re not necessarily getting information your insurance company will stand behind when push comes to shove.
If the rep says art therapy is covered and then your insurance company refuses to pay for the art therapy services you’ve received, who’s on the hook for the bill? You are. To defend yourself, you need to get EVERYTHING in writing.
Does the Art Therapist in Austin, TX Have an Art Therapy License that Commands Insurance Coverage?
In the 15 states (plus the District of Columbia) where the practice of art therapy is regulated by an art therapy license, some—but not all—of the licensing laws stipulate that insurance companies must pay for art therapy services at a level comparable to payment for mental health services like counseling.
The problem is that this obviously makes insurance reimbursement a game of geography. I am licensed to provide mental health services in Texas, Indiana, and Arizona, and none of these states have enacted an art therapy license, though Texas does have a hybrid art therapy-counseling license that is required for an individual to legally call themselves an art therapist.
The “licensed professional counselor/art therapist” credential, or LPC-AT, does not automatically command insurance coverage for art therapy in Austin, TX. To find out whether you live in an area that has an art therapy license with mandated insurance coverage, you can contact the American Art Therapy Association.
Does the Art Therapist Have Other Mental Health Licenses?
Since art therapy is a newer kid on the block compared to its talk therapy counterparts, many art therapists operate under state licensing credentials that come from talk therapy professions such as counseling.
While I have the “licensed professional counselor/art therapist” (LPC-AT) credential needed to call myself an art therapist in Austin, TX, I also have the “licensed mental health counselor” (LMHC) credential in Indiana and the “licensed professional counselor” (LPC) credential in Arizona.
The Art Therapist Might Have a Contract with Your Insurance Company
In states where mental health licenses don’t automatically command insurance coverage (TX, IN, and AZ are examples of states that do not), art therapy providers who hold other mental health licenses can apply to various insurance companies and request to be included on their “panel”.
Being paneled means that an art therapist in Austin, TX has signed a contract agreeing to a certain reimbursement rate (usually pretty low) in exchange for offering services to the company’s insureds. Therapists of all stripes used to think this was the path to self-employment, but in recent years they’ve realized that these contracts have put them on the path to poverty.
Contracts are increasingly anti-therapist, and more and more licensed mental health professionals have terminated their contracts with insurance companies in favor of cash-pay models. This is why it is increasingly difficult to find therapists (and art therapists) who accept insurance.
Double-check Before You Schedule with an Art Therapist
If you believe you’ve found an art therapist in Austin, TX who does take your insurance, double-check with both the provider and your insurance company. Don’t assume that your insurance company’s online provider directory is accurate, as these are often very outdated.
Similarly, don’t assume that online therapist directories have up-to-date information either.
What Are the Benefits of NOT Using Insurance to Pay for Art Therapy?
You have a lot of digging to do to find out if you can use your insurance policy to pay for art therapy in Austin, TX, but the digging might be worth it. And if you can’t use your insurance to pay for art therapy?
There are other benefits that await you. For one thing, you may have less to worry about in terms of your mental health treatment records being accessed by others. Several professions and occupations do experience active stigma associated with mental health treatment (which is a healthcare right, not a sign of weakness), and going with a cash-pay provider may be an option for you if you do not want an insurance company holding your records.
Paying Out-of-pocket Gives You the Freedom to Define Success on Your Terms
Cash-pay mental health services are not subject to the changing rules and regulations of profit-driven insurance companies. An art therapist in Austin, TX who operates a cash-pay practice isn’t obligated to form their treatment around artificially imposed limits on session length and treatment length.
Instead, these providers can work with clients on an individualized basis to formulate treatment that is tailored to specific needs by honoring and catering to each client’s sense of how treatment should proceed and what success looks like.
Paying Out-of-pocket Ensures a Client-centered Approach to Treatment
In this paradigm, clients have much more privilege to determine their own outcomes and select methods for achieving this. While a legitimately credentialed art therapist in Austin, TX does contribute their knowledge and skills in guiding treatment and keeping it on the right track, clients can weigh in and offer perspective on what needs to be adjusted to ensure the appropriateness and effectiveness of the services provided.
This client-centered approach is not always a feature of insurance-based treatment services.
I Believe Your Intuition Plays a Large Part in Creating a Path to Healing
As you might have guessed, I am an Austin, TX art therapist in private practice who does NOT work with insurance companies. Why not? Because I don’t honestly believe they have your best interest in mind, and I do believe that you have the power to create your own path toward healing.
An insurance company will impose treatment limits and parameters that serve the company’s purposes, not yours; instead, honing and honoring your intuition should play a large part in the organization and orchestration of treatment that is based on the limits and parameters you set to serve your own purposes.
I Offer Longer Sessions to Support the Work of Therapy
When I work with clients via art therapy in Austin, TX, I individualize treatment by engaging in collaborative efforts to create an experience that targets what clients want to work on and prioritizes each person’s unique nervous system as it responds to both internal needs and external demands.
The result is a customized, organic journey that makes sense to the client every step of the way, and this entails longer sessions than insurance companies want to pay for. Why are they longer? For one thing, longer sessions may ultimately shorten the duration of treatment.
Longer Sessions Promote Therapeutic Movement
Most importantly, longer Austin, TX art therapy sessions allow the client to suspend their nervous system in the work of therapy for more time compared to what’s possible in standard 45- or 60-minute sessions (BTW, many insurance companies are now favoring a 45-minute model because it increases their profits).
Standard-length sessions do contain plenty of time for administrative or procedural tasks, but I’ve found they don’t leave enough time for the actual therapeutic work itself. In a service like art therapy, the more time a person has for engaging in embodied, experiential processes, the more therapeutic movement a person can achieve.
Embodied, Experiential Processes Take Time
I currently offer Austin, TX art therapy in 75-minute sessions to accommodate this level of working within the body and integrating it with emotional and intellectual functioning, allowing for deep processing with or without words.
An insurance company would not value this approach, but I do and the clients I serve do as well.
Partner with an Art Therapist for Your Healing/Wellness Journey
Are you looking for an art therapist in Austin, TX who can partner with you for an individualized healing/wellness journey that centers around YOU? Contact me for a free phone consultation to learn more about how art therapy with me can help you create a better balance between the forces inside you and the forces outside you.
Although I do not accept insurance, I’m licensed to provide online art therapy in Texas, online art therapy in Indiana, and online art therapy in Arizona. My specialties include self-esteem issues, depression, anxiety, spirituality issues, trauma, grief or loss, attachment issues, and burnout.
Let’s Work on This Project Together
If you’re an adult who’s tired of what the medical industrial complex has done to the American healthcare scene and you feel excited about the possibility of creating a healing/wellness journey that is not dominated by shortcuts that shortchange you, please reach out for art therapy in Austin, TX!
Let’s get this project started together and build you up. Isn’t it about time for you to become the change you want to see?