All Kinds of Therapy surveyed 25 different wilderness therapy programs across 14 states to come up with an average $513 daily rate with an average enrollment fee of $2500*. Do not stop reading; like everything else on this website there is a great deal of guidance and recommendations to help you parse the data and investigate the declarations before making your final decision. This industry is evolving, growing and changing day to day.
Does insurance cover wilderness therapy?
The short answer is, it depends on the program.
The longer answer is, wilderness treatment is moving to becoming more affordable and insurance is one of the ways this is happening. While most require that families commit to paying out of pocket, recently there is a lot of progress in terms of insurance reimbursement. This happens in two ways. The first is seeking reimbursement for the formal therapy component. Depending on the wilderness therapy program, their model, their license, your child’s diagnosis, and your insurance plan, it is possible to get out-of-network reimbursement for individual, group, and family therapy sessions that happen during the course of treatment.
The second financial relief is that families are seeking (and receiving) a lot more reimbursement for wilderness therapy as a form of short term residential treatment.** An example of this comes from Gil Hallows, Executive Director of Legacy Outdoor Adventure in Utah, “verifying benefits and getting pre-authorizations proactively, Legacy is able to assist many families getting their sons into treatment who cannot afford to pay the full price of wilderness therapy up front.” Gil went on to further explain, “clients have been getting an average of about half of the total cost paid for by insurance.” Many other wilderness therapy programs have seen families recover as much as $20,000 of the cost of treatment, because of the types of (specialized) treatment that they are receiving.
While most insurance companies will initially deny this type of treatment, there are multiple grounds for appeal, and with support from people who understand insurance claims, families are able to recover much larger percentages of the program cost. This type of approved coverage is on the rise for two big reasons. First, as of July 2017, there is a new insurance code specifically for wilderness therapy. Research being conducted by the National Association of Therapeutic Schools and Programs (NATSAP) and Outdoor Behavioral Healthcare Council continues to legitimize the work being done in wilderness therapy. Second, there are several class action lawsuits that are occurring against insurance companies* over the past several months. Once families have gone through the extensive appeals process with insurance companies, there are many cases where the claim is still denied. Expert review indicates that the denials are illegal under federal law, which requires that if the insurance company provides intermediate care for medical issues under a specific policy, they must also provide intermediate care for mental health care (Mental Health Parity Act). The precedent of class action lawsuits provides additional leverage for families seeking reimbursement. While there is still no guarantee of reimbursement for families, the improvements in this area are incredibly encouraging.
Though not all wilderness therapy programs accept insurance or have found consistent insurance reimbursement success, Courtney Merrill, MFT and Director of Admissions from True North Wilderness Program in Vermont said, “operating a top-quality program is expensive and our efforts to help more families afford this level of care include understanding and helping families with insurance reimbursement, partnership with nonprofit scholarship organizations, and investment in the long-game of reimbursements by committing to research.”
And now for the insider tip: all the programs surveyed for this blog operated 365 days a year. Enrollment in wilderness therapy (and residential treatment programs too) ebbs and flows, with summer being the busy season for Wilderness Therapy. Enrollment is lower in the winter, and there might be a scholarship available if you enroll during the slower months. According to All Kinds of Therapy’s 2015 Economic Impact Study revealed all the treatment programs in Utah scholarshipped and discounted $19,385,587. This averages out to $328,569 per program in that year (note: this total includes residential treatment scholarships/discounts). There are also non-profits who are dedicated to supporting families and making sure that more than the 1% are able to attend a wilderness therapy programs.
Why are wilderness therapy programs expensive?
- Accessing large enough tracts of land often requires programs to contract with state and federal land managers. Permitting to operate on public land is not cheap.
- President Obama’s Executive Order #13658 signed in 2014 increased minimum pay requirements for field staff in wilderness therapy operating on federal land. Industry competition means that this particular, common hourly rate increase raised most starting field staff pay.
- To retain excellent field employees in a gratifying but also grueling job, programs provide full time staff with benefits and health Insurance.
- Staffing ratios are high, generally 1:4, and often lower depending on the time of year or particular student behaviors.
- Most states require wilderness therapy programs to be licensed. This (valuable) level of oversight requires employees complete annual paperwork, ongoing and specialized training, and requires company management to remain vigilant.
- Many wilderness therapy programs accredited themselves by a third party outside the state to ensure safety and risk management by joining CARF, Joint Accreditation, or as members of OBH, they are required to be accredited by The Association of Experiential Education (AEE) and participate in a longitudinal monitoring research project and subscription to developing and compliance with best practices.
- Many of the wilderness therapy programs surveyed helped create and continue to drive forward the independent research being done for wilderness therapy programs. Their goal is to measure safety and effectiveness, promote best practices, and produce data that helps in the quest to obtain more insurance coverage.
- Wilderness Therapy employs state-licensed, master’s and Ph.D. credentialed therapists who are choosing office hours in the outdoors.
- 17.9% of employees in Utah wilderness therapy programs have Masters or above.
- 58.5% of Wilderness Therapy programs that operate in Utah reported in 2015 that they have Bachelor's level employees working in their program. This is a skilled workforce.
Many of the wilderness therapy programs have specialty tracks or specific groups for a particular type of student that vary widely from autism spectrum disorder, gaming disorder, female vs. male, sexual maladaptive behaviors/sex addictions or substances use/addiction/recovery). Where programs differ is how the wilderness is used to effect change for the client, including the model, practices, type of client, group size, therapist in-field time and terrain/location. These are some of the nuances that you or a referring professional want to parse out before making a choice.
When you call an admissions representative, in addition to asking about these nuances of the program, be sure to ask about their rate and other fees. You can also ask if they work with any scholarship organizations, offer need-based discounts, or have seen families have success with insurance reimbursement. The lowest daily rate reported was $445 a day. There were two programs that self reported that they did not have enrollment fees and next lowest was $1200.*