FAQs

General Questions

GET STARTED - What do I do to get in?


  1. Call or email us for a phone appointment to review your case.

  2. Complete our Client Intake Form (here or ask for hard copy via email…including the Developmental and Medical history forms.)
  3. Schedule an evaluation
  4. Both parents attend the Post-evaluation feedback meeting
  5. Obtain a prescription for “Occupational Therapy” from your local doctor
  6. Start your intervention of choice




Why use Mighty Minds and Muscles?


We are a small boutique clinic that is very personal. We get to know your family and your child’s environment. We focus on quality, not quantity so that we can make a real difference. Our therapists are highly educated, vastly experienced, intriguingly curious and resourceful life-long learners.




How do I know if my child needs OT?


Although nearly everyone could benefit from some sort of O.T. intervention, we believe in helping those who really need our expertise. No one is perfect; there is a spectrum of skill performance in all areas of life. Someone is always better at and worst at nearly every skill we perform. When someone is showing functional difficulties with a skill or is performing at developmental skills much behind his or her peers, it is important to consider O.T. support. If a family or child is physically struggling, overly emotional or feeling stressed, it is important to get some support. If your family doesn’t need our support, we will tell you. The earlier the intervention takes place in the phases of development or upon signs of a disorder, the better we help you.

See our Skills Checklist page for details.




FREQUENCY - How often do we need to come for O.T.?


Our philosophy at M.M.M. is based on the theories of neurodevelopment and exercise physiology. Though not demanded, we highly recommend 2x/week minimum for traditional O.T. sessions in order to provide the brain and the muscles with the stimulations needed to produce real and efficient change. Theories of brain plasticity and muscular strengthening have demonstrated that frequency and intensity are essential for change.

Intensive programs such as Tomatis® Method and Cellfield Intervention are daily during the early phases. Please see details on the respective pages or contact us for more information.

Contact us to discuss your case and your options, as we understand that therapy interventions come with a financial commitment.




DESIGN of SENSORY SPACES - Can you help us design a sensory space (in schools or at homes)?


Absolutely! As experienced and certified providers of Sensory Processing treatment and a designer of many clinics and schools over the years, we LOVE designing sensory spaces. Although, not a licensed Interior Designer, Padra Smith, MS, OTR/L, SIPT also has formal training in Interior Design and professional experience as a Professional Organizer.

Contact padra@mightymindsandmuscles.com to discuss your design needs.




TRAINING/CONSULTING – Can you come train our teachers?


Yes, M.M.M. provides Workshops for teachers and parents. We also provide in-school consultations and/or regular visits to be part of your community. See ‘Workshops’ page for more information.




Can you work with homeschoolers?


Yes, M.M.M. therapists can provide traditional O.T. (related) services to homeschoolers through private pay or through NYC DOE R.S.A. Independent Contractor Agreements. These services may take place in our clinic space or in your home depending on schedules and locations.




Do you provide services in private and/or public schools?


Yes, M.M.M. therapists can provide services under NYC DOE R.S.A. Independent Contractor Agreements in private and public schools (school-permitting and on a limited basis).

We also provide individual or groups sessions via private pay in private schools that do not have related services in-house.

Please contact info@mightymindsandmuscles.com for further details.





Frequently asked questions

REIMBURSEMENT - With my insurance company reimburse me for services?


M.M.M. is considered an ‘out-of-network’ provider for all insurances. Each insurance company and each plan is different. Some insurance policies will cover up to 100% (after a deductible) while other provide no coverage. On average many of clients get 60-70% coverage.

Due to a shortage of our type of services in the area, some insurance companies will honor our services as 'In-Network' under a agreed upon "Gap-Exception". Call your insurance to inquire about the details.

We request that you call your insurance company BEFORE commencing services to determine your level of benefit.




Typical Therapeutic Billing Codes:


Codes for Treatment standard 45 minute treatment session:

(Usually 1 of each code per session, as each represents 15 minutes of intervention.)

Neuromuscular Reeducation - 97112

Therapeutic Procedures - 97110

Therapeutic Activities - 97530

OT Evaluation Codes:

  • OT Evaluation Code –Basic - 97165
  • OT Evaluation Code –Standard - 97166
  • OT Evaluation Code –Comprehensive - 97167
  • Developmental Evaluation – 96111




Common Diagnosis Codes


(Assigned by your pediatrician or other specialty doctor (M.D./D.O./PhD)

  • Developmental Coordination Disorder/Dyspraxia - 315.4

  • Lack of Coordination/Dysgraphia - 781.3

  • Over Anxious Childhood D/O – 313.0

  • Motor Apraxis – 784.69

  • Dyscalculia – 315.1

  • A.D.H.D – 314.01

  • Muscle Weakness – 728.87

Common Diagnosis Codes:

(Assigned by your pediatrician or other specialty doctor (M.D./D.O./PhD)

  • Unspecified D/O of Nervous system – G96.9
  • Abnormal reflex – R29.2
  • Muscle Weakness – M62.81
  • Over Anxious Childhood D/O – F93.8
  • Motor Apraxia – R48.2
  • Lack of Coordination/Dysgraphia – R27.9
  • Developmental Coordination Disorder/Dyspraxia – F82
  • Dyscalculia – F81.9
  • ADHD - F90.9
  • ADD - F90.0




Will any insurance cover OT? Will my insurance reimburse Sound-based Listening Programs like the Tomatis® Method?


Many of our families received reimbursement for our O.T. services (self-filed) but every insurance company is different. Please consult your insurance compnay for review of your benefits. SEE FAQ: REIMBURSEMENT

'Tomatis' and 'Cellfield' sessions that are done at home in without the support of and O.T. are not reimbursable. However, when the Tomatis® Method or Cellfield Intervention are done as part of clinic-based O.T. intervention with a licensed O.T., those sessions can be submitted for potential insurance reimbursement (based on your personal insurance benefits and policies).

Home-based interventions that are not part of formal O.T. sessions with direct support of a licensed Occupational Therapist are not reimbursable by medical insurance.

Request our Fee Schedule.




Will M.M.M. submit my insurance claims?


No, M.M.M. is an ‘out-of-nework’ provider that does not directly submit claims. However, we will provide you with thorough invoices that state all necessary I.D. numbers and billing codes so that you can easily submit your insurance claim via your insurance company’s claim submission system. We will also guide you on how to submit claims if you are not familiar with the process.

In the event that your insurance company needs additional documentation to support your reimbursement, we are happy to provide you with additional documentation.




COSTS - How much are your services?


Each intervention (O.T., Academic Coaching, Tomatis® Method, Cellfield, etc.) has a different fee schedule.

Our costs are based on how long you are in session, how intensively you do therapy, which intervention method is being used, your commitments to our programs.

We are very competitively priced for the area. In fact with many insurance companies we are generally significantly below the 'reasonable and customary' rate for our office zip code.




FINANCIAL RESOURCES - What other financial resources are available to me through the DOE, State or Federal Programs?


State and federal programs are available for qualified services to children of all ages. Please check with your state programs in accordance with your child’s age and disability.

0-3 years of age:

Early Intervention will cover services for children 0-3 years of age, when the development delay is appropriately identified, significant and documented.

Contact your state’s E.I. program for details.

New York:

Call 311

or

https://www.health.ny.gov/community/infants_children/early_intervention/

New Jersey:

http://www.nj.gov/health/fhs/eis/

5-21 years of age:

In accordance to the I.D.E.A. Law, all children are entitled to a free and appropriate education. The Department of Education is responsible for covering qualified, education-based services for children when a development delay is appropriately identified, significant and documented.

Contact your city’s special education program for details.

New York City:

http://schools.nyc.gov/Academics/SpecialEducation/default.htm

http://schools.nyc.gov/NR/rdonlyres/8BF37972-114D-404E-98D2-F1ACC6C3ADC4/0/CSEandCPSEContacts.pdf

3-5 years old (The Process):

http://schools.nyc.gov/NR/rdonlyres/29B3C56E-59CD-4AF5-AFDA-370E95FE9BBA/0/CPSEProcessEnglish.pdf

5-21 years of age (The Process):

http://schools.nyc.gov/Academics/SpecialEducation/IEPprocess/MakingReferral/default.htm

DOE Contacts:

http://schools.nyc.gov/NR/rdonlyres/8BF37972-114D-404E-98D2-F1ACC6C3ADC4/0/CSEandCPSEContacts.pdf

New Jersey – Jersey City DOE:

3-5 years old:

http://www.jcboe.org/boe2014/index.php?option=com_content&view=article&id=152&Itemid=576

5-21 years of age:

http://www.jcboe.org/boe2014/index.php?option=com_content&view=article&id=156&Itemid=580

New Jersey – Hoboken DOE:

http://www.hoboken.k12.nj.us/hoboken/Special%20Services/