Negotiating for Improved Reimbursement for Dialectical Behavior Therapy: A Successful Project

• Describes efforts by 2 private practice DBT teams to attain increases in reimbursement rates from third party payers
• Efforts included educating insurers on DBT’s evidence base and negotiating fees based on additional clinical demands of DBT
• Also included were treatment outcome data from their DBT programs

Dialectical Behavior Therapy (DBT) is an evidence-based treatment for borderline personality disorder that has been widely disseminated to many outpatient treatment settings. Many practitioners depend on third-party payers to fund treatment delivery. DBT requires additional clinical services not often included in outpatient therapy, including a weekly skills group led by 2 clinicians, and the requirement for clinicians to attend weekly consultation team and provide intersession contact for coaching. Standard outpatient insurance rates for individual and group sessions do not provide adequate reimbursement for the additional services of DBT. This paper describes how 2 DBT team leaders collaborated to obtain improved reimbursement for their programs. The 2 teams met with insurers, educated them about DBT, and showed outcomes from their programs to achieve large increases in reimbursement rates. The paper includes client outcome data from both programs.