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Contractor defends $150-per-student therapy rate; district reviews consultant fee options
Summary
A contracted therapy provider told the Belcourt School District board that a $150-per-student fee reflects unit-based billing, insurance midpoints and extra work (wheelchair repairs, medical letters); district staff presented statewide benchmarking and two consultant-rate options for board consideration.
A contracted therapy provider told the Belcourt School District No. 7 board that its $150-per-student rate for school-based physical therapy reflects insurance-unit billing, a marketplace midpoint and significant non-billable work.
"We charge per unit and the units are based off of what's called an 8 minute rule…so the school we charge a 150," said the provider (Speaker 6), explaining that Medicaid and commercial insurers bill in discrete units and that the district's unit pricing differs from hourly clinic rates. The speaker said the $150 fee also covers services such as wheelchair repairs, progress reports and writing medical-necessity letters.
District staff summarized statewide benchmarking that informed the proposal. "Right now for the state for school based PT services, the average is $90 an hour," said a district administrator (Speaker 7), noting that the district anonymized source data and averaged results to arrive at that figure.
Board members and administrators pushed for clarity about where services would be provided and how billing practices affect provider availability. One board member (Speaker 1) asked whether services would be provided in schools, noting that off-site appointments could create accountability and access challenges and that higher clinic rates might reduce the incentive for providers to prioritize school visits.
The discussion expanded to consultant-rate options for a separate set of proposed contracts. A consultant introduced as Earl (Speaker 9) presented two options: a lower-option with several $75 rates (classroom/athletic/culture), $150 for mental-health consulting and $100 for physical/occupational therapy; and a higher-option that generally set rates at $100 with a $115 mental-health rate. "The recommendation is to go with the $75 rate for the culture, classroom athletic, 150 for the mental health, a $100 for physical therapy," the consultant said.
Administrators told the board they had been working for two years to create consistent parameters across schools to avoid wide rate variation between districts. They also warned that setting rates too low could price providers out of the market and reduce available services for students with individualized education program (IEP) needs.
Next steps: the board directed administration to work with the assigned budget committee to produce options for rates and service delivery and to bring those options back to the board for formal consideration.
