Revenue Assessment (PA)

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As with any program, the sustainability of the program largely depends on a cost versus revenue analysis.  While there is no specific code for billing animal-assisted therapy at this time, animal-assisted therapy may be considered a modality that is incorporated into a treatment plan.  According to Complementary Health Practice Review, January 2007, “a nursing home in Missouri was reimbursed by health insurance companies after citing evidence that AAIs improved outcomes of occupational and recreational therapy interventions.”  In the same article it states that “according to the Delta Society (2005), AAT conducted by a credentialed therapist (e.g., occupational therapist, physical therapist, master of social work) may be a third-party billable service.  In contrast, AAA would be included in routine patient care plans and therefore would not be a separate billable service.  For AAT to be a billable service, the credentialed therapist must develop an individualized treatment plan incorporating an animal, with goals, interventions, and anticipated outcomes.  The credentialed therapist must provide documentation of the plan, progress, and outcomes.”  To be considered for reimbursement for the service, the use of an animal should be documented the same as any other therapeutic intervention with clear, objective measurable goals.

To establish a baseline proforma for your start-up program you could track visits for a period of one to three months in your therapy department and ask therapists to indicate which of those visits would have been appropriate for animal-assisted therapy.  At the end of the designated period of time you could then determine how your projected average reimbursement and length of stay changed with implementation of your pet therapy program.  Will patient compliance to therapy increase with the presence of an animal and therefore the length of stay will increase?  Will each patient visit or session last longer with an animal intervention because they are more motivated each session and therefore net reimbursement increases?

Once you establish the numbers for your program you can begin to determine if there is a positive financial impact to your therapy programs in addition to a positive functional outcome.  At this point you can assemble your implementation plan and present it for approval for the program.

Back to: Implementation of Animal-Assisted Programs – Pennsylvania

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