Date and Time: Wednesday, June 25, 6 – 7:30 PM
Chairperson(s): Emily Walker, OT, OTR, Allyson Lewis, OT, OTR, Rosa Colorado, OT, OTR
Location: Zoom - to be sent out the day before the event
Title: Navigating Reimbursement for Mental Health Occupational Therapy Services in Massachusetts
Speaker: Dr. Sherlyn (Sherry) Fenton, OT, OTD, M. Eng
Learning Objectives:
By the end of the session, participants will:
- Identify key public and private payers for mental health OT services in Massachusetts, including Medicaid (MassHealth), Medicare, and private insurance, and recognize how reimbursement policies differ across these payers.
- Learn to apply appropriate CPT codes, understand medical necessity requirements, and document services effectively to maximize reimbursement and comply with insurance guidelines.
- Explore common barriers to reimbursement, including denials and authorization issues, and develop strategies for appealing claims and advocating for OT services in mental health settings.
Focus:
This session provides occupational therapy practitioners with essential knowledge and strategies to successfully navigate the reimbursement process for mental health services in Massachusetts. Participants will explore key payers, including Medicaid (MassHealth), Medicare, and private insurance, and learn how to apply appropriate billing codes, meet documentation requirements, and address common reimbursement challenges. This session will equip attendees with the tools needed to optimize reimbursement, advocate for OT services in mental health settings, and ensure financial sustainability in their practice.
Biography:
Dr. Sherlyn Fenton, OT, OTD, M. Eng., owns Community Physical Therapy LLC, located in Hanover, MA. She most recently served as Chief Development Officer for a nonprofit skilled nursing facility and Director of Quality and Compliance for a national non-profit health and human services organization.
She earned her Bachelor of Science in Occupational Therapy from Tufts University in 1987. While practicing in physical rehabilitation and industrial medicine settings, she earned her master’s degree from the University of Massachusetts Lowell School of Environmental Engineering, focusing on ergonomics and human factors, in 1997. Ms. Fenton returned to Tufts University and earned her Doctor of Occupational Therapy in 2010. Her research explored individuals’ perceptions of dignified care when they required assistance during self-care activities of daily living.
Doctor Fenton has directed rehabilitation in the acute, sub-acute, long-term care, home care, and outpatient settings. She has enjoyed her roles as a clinician, manager, consultant, author, lecturer, and entrepreneur in rehabilitation, human factors, and performance redesign.
Serving the healthcare industry for over thirty-eight years, Sherry has developed companies, marketing tools, quality systems, and corporate compliance programs for healthcare communities. She has evaluated software applications for operations and developed clinical and technological systems while overseeing all aspects of Rehabilitation Services, from recruitment to evidence-based research.
Dr. Fenton is the past President of the Massachusetts Association for Occupational Therapy (MAOT) and served as Vice Chair for the American Occupational Therapy Association’s (AOTA) Committee for State Association Presidents (ASAP) and Representative of ASAP to AOTA’s Representative Assembly. Sherry is currently the Reimbursement Representative for MAOT.
References:
American Occupational Therapy Association. (n.d.). Billing and coding occupational therapy for mental and behavioral health services. https://www.aota.org
American Occupational Therapy Association. (n.d.). Coding and billing resources for OTs and OTAs. https://www.aota.org
American Occupational Therapy Association. (n.d.). Occupational therapy scope of practice. https://www.aota.org
American Occupational Therapy Association. (n.d.). Occupational therapy's distinct value in mental health promotion, prevention, and intervention across the lifespan. https://www.aota.org
CGS Administrators, LLC. (2025, May 23). Billing and coding: Outpatient physical and occupational therapy services (Article ID: A57067). Centers for Medicare & Medicaid Services. https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57067
Commonwealth of Massachusetts. (n.d.). CBHI in-home therapy practice guidelines. Mass.gov. https://www.mass.gov
Commonwealth of Massachusetts. (n.d.). MassHealth guidelines for medical necessity determination for occupational therapy. Mass.gov. https://www.mass.gov
Bottom of Form
Logan, V. (2025). Meyer & Sasse (2025): Early’s Mental Health Concepts and Techniques for Occupational Therapy. In Occupational Therapy in Mental Health (pp. 1–2). Lippincott Williams & Wilkins.
This event will close on Tuesday, June 24 at 4:00 p.m. or when the event has reached full capacity.
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