Music Therapy

What is music therapy?
Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. (American Music Therapy Association definition, 2005)

What do music therapists do?
Music therapists assess emotional well-being, physical health, social functioning, communication abilities, and cognitive skills through musical responses; design music sessions for individuals and groups based on client needs using music improvisation, receptive music listening, song writing, lyric discussion, music and imagery, music performance, and learning through music; participate in interdisciplinary treatment planning, ongoing evaluation, and follow up.

Who can benefit from music therapy?
Children, adolescents, adults, and the elderly with mental health needs, developmental and learning disabilities, Alzheimer's disease and other aging related conditions, substance abuse problems, brain injuries, physical disabilities, and acute and chronic pain, including mothers in labor.

Where do music therapists work?
Music therapists work in psychiatric hospitals, rehabilitative facilities, medical hospitals, outpatient clinics, day care treatment centers, agencies serving developmentally disabled persons, community mental health centers, drug and alcohol programs, senior centers, nursing homes, hospice programs, correctional facilities, halfway houses, schools, and private practice.

What is the history of music therapy as a health care profession?
The idea of music as a healing influence which could affect health and behavior is as least as old as the writings of Aristotle and Plato. The 20th century discipline began after World War I and World War II when community musicians of all types, both amateur and professional, went to Veterans hospitals around the country to play for the thousands of veterans suffering both physical and emotional trauma from the wars. The patients' notable physical and emotional responses to music led the doctors and nurses to request the hiring of musicians by the hospitals. It was soon evident that the hospital musicians needed some prior training before entering the facility and so the demand grew for a college curriculum. The first music therapy degree program in the world, founded at Michigan State University in 1944, celebrated its 50th anniversary in 1994. The American Music Therapy Association was founded in 1998 as a union of the National Association for Music Therapy and the American Association for Music therapy.

Who is qualified to practice music therapy?
Persons who complete one of the approved college music therapy curricula (including an internship) are then eligible to sit for the national examination offered by the Certification Board for Music Therapists. Music therapists who successfully complete the independently administered examination hold the music therapist-board certified credential (MT-BC).
The National Music Therapy Registry (NMTR) serves qualified music therapy professionals with the following designations: RMT, CMT, ACMT. These individuals have met accepted educational and clinical training standards and are qualified to practice music therapy.

Is there research to support music therapy?
AMTA promotes a vast amount of research exploring the benefits of music as therapy through publication of the Journal of Music Therapy, Music Therapy Perspectives and other sources. A substantial body of literature exists to support the effectiveness of music therapy.

What are some misconceptions about music therapy?
That the client or patient has to have some particular music ability to benefit from music therapy -- they do not. That there is one particular style of music that is more therapeutic than all the rest -- this is not the case. All styles of music can be useful in effecting change in a client or patient's life. The individual's preferences, circumstances and need for treatment, and the client or patient's goals help to determine the types of music a music therapist may use.


How can music therapy techniques be applied by healthy individuals?
Healthy individuals can use music for stress reduction via active music making, such as drumming, as well as passive listening for relaxation. Music is often a vital support for physical exercise. Music therapy assisted labor and delivery may also be included in this category since pregnancy is regarded as a normal part of women's life cycles.

How is music therapy utilized in hospitals?
Music is used in general hospitals to: alleviate pain in conjunction with anesthesia or pain medication: elevate patients' mood and counteract depression; promote movement for physical rehabilitation; calm or sedate, often to induce sleep; counteract apprehension or fear; and lessen muscle tension for the purpose of relaxation, including the autonomic nervous system.

How is music therapy utilized in nursing homes?
Music is used with elderly persons to increase or maintain their level of physical, mental, and social/emotional functioning. The sensory and intellectual stimulation of music can help maintain a person's quality of life.

How is music therapy utilized in schools?
Music therapists are often hired in schools to provide music therapy services listed on the Individualized Education Plan for mainstreamed special learners. Music learning is used to strengthen nonmusical areas such as communication skills and physical coordination skills which are important for daily life.

How is music therapy utilized in psychiatric facilities?
Music therapy allows persons with mental health needs to: explore personal feelings, make positive changes in mood and emotional states, have a sense of control over life through successful experiences, practice problem solving, and resolve conflicts leading to stronger family and peer relationships.


Is music therapy a reimbursable service?

Medicare
Since 1994, music therapy has been identified as a reimbursable service under benefits for Partial Hospitalization Programs (PHP). Falling under the heading of Activity Therapy, the interventions cannot be purely recreational or diversionary in nature and must be individualized and based on goals specified in the treatment plan. The current HCPCS Code for PHP is G0176.
The music therapy must be considered an active treatment by meeting the following criteria:

Be prescribed by a physician;

Be reasonable and necessary for the treatment of the individual’s illness or injury;

Be goal directed and based on a documented treatment plan;

The goal of treatment cannot be to merely maintain current level of functioning; the individual must exhibit some level of improvement.

Medicaid
As Medicaid programs vary from state-to-state, so do the Medicaid coverage avenues for music therapy services. Some private practice music therapists have successfully applied for Medicaid provider numbers within their states. Some states offer waiver programs in which music therapy can be covered. In some situations, although music therapy is not specifically listed as a covered service, due to functional outcomes achieved, music therapy interventions can fall under an existing treatment category such as community support, rehabilitation, or habilitation.
Examples:

Arizona
Medicaid coverage for music therapy provided to individuals with developmental disabilities; originally recognized as a habilitation service but also considered as a socialization service.
Minnesota
Individual music therapist received provider number to service clients with mental illness and developmental disabilities. Waiver program for children with developmental disabilities provides coverage for music therapy.

Pennsylvania
Department of Aging Waiver program allows Medicaid payment for music therapy provided in a community based setting. Music therapy is listed under health and mental health related counseling services.

North Carolina
Medicaid reimbursement is available for music therapy services through the Community Alternatives Program (CAP) for clients with developmental disabilities.

Indiana
Waiver program for children with developmental disabilities offers coverage for music therapy.

Michigan
Music therapy is a covered service under the state’s Medicaid Children’s Waiver Program.

Private Insurance
The number of success stories involving third party reimbursement for the provision of music therapy services continues to grow. Over the past twelve years a growing public demand for music therapy services has been accompanied by a demand for third party reimbursement. In response to the increasing demand the music therapy profession has worked to facilitate the reimbursement process for clients of music therapy services.

The American Music Therapy Association now estimates that at least 20% of music therapists receive third party reimbursement for the services they provide. This number is expected to increase exponentially as music therapy occupies a strong position in the health care industry.

Insurance companies are recognizing the advantages of including music therapy as a benefit as they respond to the increasing market demand for greater patient choice of health care services. Companies like, Blue Cross/Blue Shield, Humana, Great West Life, Aetna, Metropolitan, and Provident have reimbursed for music therapy services on a case-by-case basis, based on medical necessity.

Music therapy is comparable to other health professions like occupational therapy and physical therapy in that individual assessments are provided for each client, service must be found reasonable and necessary for the individual’s illness or injury and interventions include a goal-directed documented treatment plan.

Like other therapies, music therapy is typically pre-approved for coverage or reimbursement, and is found to be reimbursable when deemed medically necessary to reach the treatment goals of the individual patient. Therefore, reimbursement for services is determined on a case-by-case basis and is available in a large variety of health care settings, with patients with varying diagnoses.

Other Sources
Additional sources for reimbursement and financing of music therapy services include: many state departments of mental health, state departments of mental retardation/developmental disabilities, state adoption subsidy programs, private auto insurance, employee worker’s compensation, county boards of mental retardation/developmental disabilities, IDEA Part B related services funds, foundations, grants, and private pay.

What is the American Music Therapy Association?
The American Music Therapy Association is the largest professional association which represents over 5,000 music therapists, corporate members and related associations worldwide. Founded in 1998, its mission is the progressive development of the therapeutic use of music in rehabilitation, special education, and community settings. AMTA sets the education and clinical training standards for music therapists. Predecessors to the American Music Therapy Association included the National Association for Music Therapy founded in 1950 and the American Association for Music Therapy founded in 1971.

What is a typical music therapy session like?
Since music therapists serve a wide variety of persons with many different types of needs there is no such thing as an overall typical session. Sessions are designed and music selected based on the individual client's treatment plan.

What is the future of music therapy?
The future of music therapy is promising because state of the art music therapy research in physical rehabilitation, Alzheimer's disease, and psychoneuroimmunology is documenting the effectiveness of music therapy in terms that are important in the context of a biological medical model.