Music therapy is not routinely covered by most health insurance plans in the United States, but coverage is possible in specific situations depending on your insurer, your state, your diagnosis, and how the therapy is billed. The path to reimbursement exists, though it requires more legwork than a typical medical claim.
What Most Private Insurers Say
Major private insurers generally do not include music therapy as a standard benefit. Aetna, for example, explicitly classifies music therapy as “experimental, investigational, or unproven” in its clinical policy bulletins, stating that “the effectiveness of these approaches has not been established.” Other large carriers take similar positions, treating music therapy as a complementary or alternative intervention rather than a mainstream medical service.
That said, “not a standard benefit” is different from “never covered.” Some plans will reimburse music therapy when it’s delivered as part of a broader treatment program, such as inpatient rehabilitation or behavioral health services, rather than billed as a standalone session. The key distinction is whether the therapy is framed as addressing a specific, measurable clinical goal (improving speech function after a stroke, for instance) versus being offered as a general wellness service.
How Music Therapists Get Reimbursed
When music therapy is successfully billed to insurance, it typically uses a billing code designed for “therapeutic activities,” a broad category that covers one-on-one goal-directed interventions in 15-minute increments. This is the most commonly used code among music therapists who bill insurance. The service isn’t labeled “music therapy” on the claim. Instead, it’s categorized under a recognized rehabilitation framework, which makes it more likely to be processed without a denial.
A study examining 55 documented reimbursement cases across five states found that licensed music therapists who were successfully reimbursed received an average of about $96 per hour. Roughly two-thirds of those successful cases involved a referral from a physician or physician’s assistant, which suggests that having a doctor’s order significantly improves your chances of getting the service covered. Without that referral, many insurers won’t consider the claim at all.
Medicare and Medicaid
Medicare does not have a specific, nationwide benefit for music therapy. However, music therapy services can sometimes be covered when they’re part of a broader care plan in certain settings. Hospice care is the most common example: Medicare-certified hospice programs sometimes employ music therapists, and their services are bundled into the overall hospice benefit rather than billed separately.
Medicaid coverage varies dramatically by state. Some states include music therapy under Home and Community-Based Services (HCBS) waivers, which provide support for people with intellectual disabilities, autism, or other developmental conditions who live in the community rather than in institutions. Pennsylvania’s Consolidated Waiver, for instance, specifically lists “Music, Art and Equine Assisted Therapy” as covered services for individuals with intellectual disabilities, autism, or developmental disabilities. Other states have similar waiver programs, but you’d need to check your specific state’s Medicaid waiver documents to know whether music therapy is included.
Veterans and Military Coverage
The VA healthcare system is one of the more accessible pathways to covered music therapy. The Department of Veterans Affairs employs board-certified music therapists across its medical facilities and describes the service as an evidence-based clinical intervention. Veterans can access music therapy by asking their primary care provider to place a consult, though specific criteria based on the individual treatment plan need to be met.
Within VA music therapy, veterans may work on therapeutic goals through instrument playing, songwriting, music listening, lyric analysis, and other structured musical experiences. The VA frames these sessions as targeting physical, social, emotional, cognitive, and communication functioning, not simply as recreational music-making. This clinical framing is a big part of why the VA covers it when many private insurers don’t.
What Improves Your Chances of Coverage
If you want to pursue insurance reimbursement for music therapy, several factors make approval more likely:
- Board-certified therapist. Look for the MT-BC credential (Music Therapist, Board Certified). Insurers that do reimburse for music therapy almost always require this certification. Some states also have licensure requirements that must be met.
- Physician referral. A written order from your doctor linking music therapy to a specific diagnosis and measurable treatment goal is one of the strongest predictors of successful reimbursement.
- Functional goals, not wellness goals. Claims tied to outcomes like “improve verbal communication” or “increase range of motion in right arm” are treated differently than claims for stress reduction or general well-being. The more specific and measurable the goal, the better.
- Clinical setting. Music therapy delivered within a hospital, rehabilitation center, or hospice program is more likely to be covered than sessions in a private practice or community setting, partly because it can be bundled into a broader treatment program.
Paying Out of Pocket
Because insurance coverage remains inconsistent, many people pay for music therapy directly. Session rates vary widely by region and setting, but typically fall in the range of $75 to $150 per hour for individual sessions. Some music therapists offer sliding-scale fees, and group sessions are generally less expensive per person. If you’re paying out of pocket, you can ask your therapist for a superbill, a detailed receipt with diagnosis and procedure codes, that you can submit to your insurer for potential partial reimbursement. There’s no guarantee the claim will be paid, but some plans with out-of-network benefits will reimburse a portion.
Health savings accounts (HSAs) and flexible spending accounts (FSAs) may also cover music therapy if you have a letter of medical necessity from your doctor. This won’t reduce the sticker price, but it lets you pay with pre-tax dollars, effectively giving you a discount equal to your tax rate.