As with all new programs, funding is a major concern. For large organization, e.g., hospitals, they have been able to see CET as part of their total services and have reassigned staff and resources to CET. For most organizations, billing CET as outpatient mental health services (group and individual therapy) or as casemanagement services has been successful.
The initial costs for dissemination training has largely been funded by foundation grants. The Center for Cognition and Recovery has had many years of very successful experience in writing grant proposals that have been funded. We are able to provide our dissemination partners with copies of these grant proposals and will work with you on funding strategies including likely foundations in your geographic area.
1. Will it be difficult for us to get Medicare approvals? We have had no problem billing for the groups and individuals sessions to Medicare and other 3rd party insurance. What are the numbers that this falls under? 90853 for group, 90804 or 90806 for individual. We also bill the clients $10 per session for the computer training. This serves two purposes, 1) to get the client to be more involved and 2) provides a small income stream for this non covered service.
2. Will Medicaid pay for CET? In Ohio and PA, Medicaid does pay for CET as group therapy or as case management services (CPST individual and group services). We are able and willing to work with you on your specific Medicaid issues. It could well become a significant income stream for your agency as it has at some of our sites.
3. Will billing for CET cover the on going costs of operating the CET program? Our experience has been that Medicaid, and to a lesser extent Medicare and other 3rd party payers, are able to cover the costs of CET and to generate a surplus. Having a 90% attendance rate means that CET clients provide a dependable funding stream. We have also seen CET graduates attend more groups and have improved vocational experiences.
4. Can you help me get funding for the training? Yes, we have helped our dissemination partners with applying for major foundation grants that cover the full cost of the training or to write contracts for state departments of mental health. Usually, you can also get funding for staff training time and expenses.