Using CMS MTM for Music Therapy Services
1. Request a Prescription for a referral and Letter of Medical Necessity and email to gladlymusic.llc@gmail.com
Ask your child’s primary care physician (PCP), pediatrician, or relevant specialist (e.g., neurologist, developmental pediatrician) for a written referral and letter of medical necessity for music therapy.
The letter should include:
Client’s full name and date of birth
Diagnosis or reason for referral
Statement that music therapy is medically necessary due to (areas of need)
Diagnosis Code
2. Complete the Intake Form and make sure to include CMS Member ID number.
If you have been approved for music therapy in the past, please provide me with the existing authorization number via email.