The Music Therapy Crisis in Florida: Aftermath
- Stephen Choate
- Jul 21, 2025
- 8 min read
Music therapists in Florida may have averted a catastrophe, but the real work is just beginning.
Just weeks ago, the music therapy community in Florida found itself in an unanticipated crisis, where private practice owners and therapists went unpaid by the primary payer of services in the state - without warning and without answers. Across the state, providers suddenly had to weigh their options of walking away from insurance funding and redesigning their business models, laying off their teams, rolling the dice and continuing operations in hopes of getting paid, or even closing their doors altogether. Read our full analysis here.
What Happened Next?
The fiscal intermediary through which most music therapists in the state access Medicaid funds, Medical Transportation Management (MTM), disclosed it was under an internal audit and was temporarily unable to release payments to providers. And just days later, MTM announced a payment schedule to reconcile all providers’ claims over the next two weeks.
In summary, providers were paid, and most were reportedly reimbursed properly. So, this was just a false alarm and everything is back to normal, right? Well, not exactly…
Though MTM has always been relatively consistent in their payments (with some minor exceptions), this ordeal in the Florida music therapy community underscores a more significant concern - not so much the relationship with MTM, but the viability of the HCBS waiver itself.
In the midst of MTM’s internal audit and payment freeze, they also announced an immediate change for expressive therapies providers: that each of these therapies (music therapy, art therapy, etc.) would be limited to only one session per member per week. Now, for some, that may not sound like a major adjustment. But many providers built their entire business models on this waiver. For them, cutting to only one session per week could cut their revenue substantially. The change also has serious implications for those who matter most: the vulnerable people who rely on and benefit from these services.
It could also be argued that the change actually improves the state of the HCBS waiver program. While limiting services raises clinical and ethical concerns, capping complementary services like music therapy may help keep the program sustainable.
What Now?
By and large, music therapists working in private practice throughout the state are a bit shaken, and rightfully so. Most everyone, from employees to large practice owners, reached a place of accepting the unfortunate reality that they would likely have to find a new way of financing care and move on without this option upon which so many had found a sense of stability. But once those funds dropped, and everything appeared to be “back to normal,” therapists were left with the same question, inevitably on their minds: Will this happen again?
Obviously, no one knows.
Fortunately, many providers made it to the other side of this story. And while the dust does appear to have settled, there’s no guarantee we won’t see this happen again. In fact, when it comes to healthcare, change is perhaps the only guarantee.
Our previous article on this situation explored some of the lessons private practice music therapists are learning through this experience - the need for cash reserves, the reality of key client risk, and the imperative of strengthening the field’s position in the market. Whether you’re a sole proprietor working for yourself, an employee of a private practice, or a larger business owner, here are a few other lessons we can infer.
A payer can amend or terminate their agreements at nearly any time.
There’s some nuance to this, of course, but unless you have an iron clad contract guaranteeing services over a specific duration at a set rate, there’s no certainty your business arrangements will continue indefinitely. In fact, even with such an agreement, if a company becomes insolvent or goes out of business and there’s no money to collect, you are likely left without any recourse.
A contract is only as good as your ability to enforce it.
This is a matter of leverage. When MTM rolled out their new contract about a year ago, I heard other providers say they were concerned about it and may not even sign. But the truth was (and still is) that, if they want to participate in the HCBS waiver program, this is essentially their only option. And that’s because MTM has leverage as the sole intermediary for these funds.
When questions circled about MTM’s solvency and why they weren’t making payments in the beginning of this debacle, there was some discussion amongst providers about pursuing legal action. But here’s the thing: Even if MTM violated their own contract, lawyers are expensive. Yes, some will take cases on contingency, but only if they believe they have a strong chance of winning your case or obtaining some kind of settlement. But if the other party truly is insolvent, there’s nothing to be collected.
You can spend all the money you like on chasing justice from a bad deal, a sleazy ex-partner, a client that never paid you, the list goes on… But, at some point, you have to ask yourself: At what cost? The key is to discern trustworthy partners, good deals, viable arrangements, from the outset.
The future of Medicaid is certainly uncertain.
As many have already noted, the timing of the Music Therapy Crisis in Florida is interesting, in that it coincided with the proposing and passing of the One Big Beautiful Bill Act (H.R. 1). While no one knows exactly what the future holds, here are some of its projected consequences:
Those are some sobering predictions, and they could very well impact music therapists.
A Sustainable Future
One of the unfortunate realities we, as expressive therapies practitioners, have to accept is that our disciplines are not considered “core services.” But while we may not be considered essential in the way disciplines like nursing or social work are, that doesn’t mean we can’t prove ourselves valuable.
“You can’t improve what you don’t measure.”
In our previous article, we advocated for additional research on music therapy as it relates to clinical outcomes, revenue generation, cost savings, and more. And while there is a strong need for this literature, there are also steps we can take right now to evidence the value of our work - no matter the setting or the way those programs are funded.
Data Collection
To do this, you need data - quantitative and qualitative data.
Quantitative data refers to the things we can measure by quantity - session units delivered, time spent with clients, dollars raised through a fundraiser, or the number of patients who came to your company because it offered music therapy. Tracking these metrics is essential to evidencing your worth. But they’re not everything.
Qualitative data encompasses those aspects that speak to the quality of our work - the experiences, the testimonies, the impact we make. And to measure those characteristics, we have to tell our stories - more specifically - we have to tell our clients’ stories.
As therapists (and as people), we deal with emotions every day. And emotions are incredibly powerful. We’ve all seen this in our work. But emotions are also an incredibly valuable tool in marketing - they’re what drive people to act.
This is a tremendous opportunity for us. By tapping into this emotional core of our work, we are able to harness the sort of passion that truly moves people and ultimately, inspires them to support us. There’s no better way to do this than telling people what you do.
That child losing her parent who wrote a song to cope. That family who says they receive every therapy but their son benefits from music therapy more than any other. That wife, who hasn’t seen her husband lucid for months, and suddenly, he’s singing a song and holding her hand like they used to in church. These are the things those other services can’t do.
Track them. Save them. Share them.
Collaboration
Before I worked in private practice, I had the incredible opportunity to design and implement a hospice music therapy program. I tracked everything I could. But I also developed relationships - with nurses, social workers, IT, business reps - everyone I could. We led trainings and in-services together. We did an overview of the program in new hire orientation. We learned about each other’s contributions to advance the mission of the organization as a whole.
Over time, I found that people genuinely wanted to help me - not as some sort of favor - but because I showed them the value in our program.
At the end of the second year, the company launched a massive rebranding campaign. When they decided they wanted to feature a real patient, the marketing team asked to film a music therapy session, and we produced it as an award-winning commercial.
When I moved on to pursue another opportunity, the Chief Nursing Officer looked at me and said, “Music therapy is a part of who we are. We will always have it here.” That program continues today.
We transformed an ancillary program into a key differentiator for the company - a testament to the organization’s commitment to caring for our community.
If you’re in a large organization, get to know your team. Share the stories with your marketing and communications department (they always need stories). Share the testimonies with your boss. When a client or family raves about the benefit you provided to their loved one, consider asking them to share it with the administrator. If you’re in private practice, seek permission to feature a thankful client or share their story on social media. That might not help you obtain funds from insurance, but it can help other families to develop confidence in your work.
Practice, Practice, Practice…
While the Music Therapy Crisis in Florida appears to be resolved for now, it serves as a telling indicator with broader implications for us all.
This isn’t just a crisis for music therapists in Florida - it’s an impending crisis for our entire field.
No matter where you work, no matter how your program is financed, the truth is: There’s no such thing as job security. What matters is that we learn to leverage the resources at our disposal to sustain the meaningful work we do. Maybe that looks like educating your coworkers about the value you’re bringing to patients. Or maybe it’s illustrating how your services are worth your asking price as you aim to obtain more private pay business, and become less dependent on Medicaid dollars.
This world needs music therapy. We know that, but we still face an uphill climb in our task of ensuring its longevity. And it’s up to us to obtain the resources we need to sustain it.
Whoever you are, wherever you serve, just be sure you keep doing one thing: Practice.
Practice reminding yourself of why you chose this field. Practice learning new skills to strengthen your position and provide opportunities for the next generation of therapists. Practice resilience. Practice adapting. Practice growth.
Practice music therapy. Practice measuring the impact of what you do and fighting for its rightful place in the healthcare landscape.
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