Does insurance pay for sensory integration therapy?
Sometimes. But if not, the therapist can bill for activities that are done during SI therapy, versus using only a sensory integration code (97533). For example, there is a billing code known as neuromuscular reeducation (97112) which can be used for balance activities, another code for therapeutic procedure (97110) such as exercises for strength and endurance, one for therapeutic activities (97530), and still another for massage (97124). Analyzing what was done by the occupational therapist (or physical therapist (PT)) during the session is a better way to code. Since SPD is only a “working” diagnosis, meaning that is what the therapist is working on, then maybe billing can occur under the primary diagnoses the child has such as hypotonia, cerebral palsy, feeding disorder, etc. It is NEVER suggested that you should lie to your insurance company, just think smart when completing the paperwork.
