Frequently asked questions
Insurance
Does my insurance cover occupational therapy?
Many PPO plans cover out-of-network occupational therapy. Call the member line and ask about coverage for CPT codes 97166 (OT Evaluation - Mod Complexity), 97530 (OT Therapeutic Activities), and 97150 (OT Therapeutic activities Group Setting). We provide a monthly super bill to submit.
How much does my plan reimburse for an out-of-network occupational therapist?
Reimbursement varies by plan. Ask for the out-of-network rate per visit, and whether a deductible applies before reimbursement starts.
How much of each bill will my plan pay?
Plans typically pay 50 to 80 percent of their allowed amount, not of our fee. Ask for the allowed amount per CPT code so you can estimate your net cost.
How do I get reimbursed?
Pay at the time of service, then submit our superbill through your insurance member portal or by mail. We issue superbills monthly with all codes and license numbers included.
How is the reimbursement paid out?
Most plans reimburse you directly by check or deposit; nothing routes through us. Confirm whether payments go to you.
Do I need my doctor’s approval or pre-authorization?
An OT evaluation usually needs no referral, but some plans require pre-authorization before therapy visits count. Confirm both before the first session.
What if my insurance doesn't cover the specific type of OT I need? (Gap exceptions)
You may be able to request a coverage or “gap” exception for specialized OT services, such as Sensory Integration (SI) or Comprehensive Behavioral Intervention for Tics (CBIT). Your insurance may require a physician’s prescription and documentation of medical necessity. Requirements vary by plan, so we recommend contacting your insurance provider directly to ask about coverage exceptions.
Payment
What does a session cost?
Fees depend on the service and session length. We give you the full rate sheet before you commit to anything, so nothing on an invoice is a surprise.
How do superbills work?
A superbill is an itemized receipt with our license numbers, your insurance information, diagnoses, and CPT codes. Occupational therapy sessions are billed under 97530, evaluations under 97166, and group sessions under 97150. Superbills for paid sessions are emailed the following month.
Do you accept Regional Center funding?
We are a contracted provider for Lanterman Regional Center and Eastern Los Angeles Regional Center, most often for early intervention with children under three. For all other OT and social skills group services, we do accept Self-Determination Funding.
Getting started
What does an evaluation include?
Client/caregiver interview, hands-on clinical observations, and standardized testing across sensory, motor, social, emotional, and self-care skills. You will receive a written OT evaluation report, recommendations, goals, and a plan.
Do I need a referral to start?
No referral is needed to book an evaluation. Some insurance plans require one for reimbursement, so check your plan before the first visit.
How long does therapy usually last?
CBIT runs 8-10 sessions. PEERs runs 14-16 weeks. Ongoing sensory integration therapy is reviewed with you regularly, and we adjust or finish as goals are met.
Scheduling
What are your hours?
Monday to Friday, 9 AM to 6 PM at both Pasadena clinics, by appointment.
What is your cancellation policy?
We hold a weekly slot for you, so notice matters. If you need to stop or change your regular time, we ask for 2 weeks' written notice so we can offer the spot to another family. The full policy is in your service agreement, which you'll review before your first session.
Do you offer telehealth?
Telehealth is available to clients who are located in California at the time of service. It’s a great option for parent coaching, the Safe and Sound Protocol, and for clients who would like to switch a current OT session to telehealth when appropriate.
Definitions
What is sensory integration?
How the brain organizes input from the senses into useful responses. Therapy strengthens that processing through structured, playful movement and touch.
What is CBIT?
Comprehensive Behavioral Intervention for Tics: An evidence-based program that builds awareness of tic urges, teaches competing responses, and helps with how emotions and lifestyle can activate or exacerbate tics. Typically 8-10 sessions in the clinic and via telehealth in California when appropriate.
What is UCLA PEERS® Social Skills Groups?
Developed at UCLA by Dr. Elizabeth Laugeson, PEERS® is an evidence-based social skills program backed by years of research on helping kids and teens make and keep friends. Our occupational therapists completed certified training through the UCLA PEERS® Clinic, so each group follows the program as it was designed and studied. Over 14 to 16 weeks in clinic, kids and teens practice real social skills while parents meet in their own group, helping those skills carry into daily life.
What is the Safe and Sound Protocol?
Developed by Dr. Stephen Porges and grounded in his Polyvagal Theory, the Safe and Sound Protocol is a listening-based therapy that uses specially filtered music to help calm the nervous system and support regulation. Our occupational therapists are trained and certified through Unyte, the program's official provider, and guide each step so the pace feels right for your family. Sessions can happen in clinic or remotely, making it easy to fit into daily life.
What families say
“This family-focused approach felt more productive than other therapies we've had. Our parent group was informational, educational, and supportive. Our autistic son was initially opposed to joining but enthusiastic and happy during the classes, and he even said he enjoyed them.”
"Would recommend The Sensory Brain!! Very structured and goal-oriented, the office is spacious and welcoming for all! "
“The therapists did a wonderful job helping my teenage boy set up routines around exercise, self-reflection, touch interaction with the world, learning about how different physical senses interact with the brain, and so much more. We had a great experience and highly recommend The Sensory Brain for your family.”
“The entire experience, whether 1 on 1 or from their UCLA peers program, really lifted and elevated my son to where he needs to be. They are understand and caring and take pride in their work. Highly recommend, they help the lost ones I know they did that for me and my family. ”
“From the get-go she would have suggestions and tips on things to work with him at home, and they were all so insightfully helpful. It alleviated so much of my anxiety as a parent.”
“ We worked together to track and log severity and impact data over time. We built a toolkit of competing responses for situations when I want or need to openly tic less. By the end, I had not only built more self-awareness but also self-compassion. ”
“My 9 year old son has ADHD. He went to Sensory Brain to help him with his ‘big feelings’ for about a year with great results.”
“We have seen a lot of improvements and he is now more willing to try and explore different textures. We’ve seen many therapists and I can attest that she is the best among them.”
