Insurance & Payment
We work to make therapy accessible and affordable. Our team handles the insurance details so you can focus on progress.
Contact us to verify your specific plan and current in-network status.
Don't see your carrier? Contact us — we accept many additional plans and can check your specific coverage.
Insurance terminology can be confusing. Here's what each term means in plain language.
The amount you pay out-of-pocket for covered services before your insurance begins to pay. For example, if your deductible is $1,000, you pay the first $1,000 of covered services yourself each plan year.
A fixed dollar amount you pay at the time of each visit. For instance, your plan might require a $30 copay per speech therapy session after your deductible is met.
After meeting your deductible, coinsurance is the percentage of costs you share with your insurer. If your coinsurance is 20%, your plan pays 80% and you pay 20% of the allowed amount per session.
The most you will pay for covered services in a plan year. Once you reach this limit, your insurance covers 100% of additional covered costs for the rest of the year.
Some plans require approval before speech therapy begins. We handle the prior authorization process on your behalf, submitting documentation of medical necessity so you can start therapy as quickly as possible.
We navigate the insurance process for you — start to finish.
Before your appointment, we contact your insurance carrier to confirm your speech therapy coverage, deductible status, and copay amounts.
If your plan requires prior authorization, our team prepares and submits all necessary clinical documentation on your behalf.
After each session, we file claims electronically so you receive maximum reimbursement with minimal paperwork on your end.
If we are out-of-network with your plan, we can provide detailed superbills with all required billing codes so you can submit for reimbursement directly.
Understanding the difference helps you estimate your costs and plan accordingly.
| Feature | In-Network | Out-of-Network |
|---|---|---|
| Cost per session | Copay or coinsurance only (often $20–$60) | Full session cost, then submit for partial reimbursement |
| Claims submission | We submit directly — no paperwork for you | We provide superbills; you submit to your insurer |
| Reimbursement rate | Determined by contracted rate | Typically 50–80% of allowed amount after deductible |
| Prior authorization | We handle all authorization | May still be required depending on your plan |
| Counts toward deductible | Yes | Often yes — check your specific plan |
Yes — most major health insurance plans cover speech-language pathology services when medically necessary. Coverage typically requires a documented diagnosis and, in many cases, a physician referral or prescription.
Medical necessity means your insurer needs clinical evidence that therapy is required to treat a health condition — not simply to improve communication skills. We provide thorough evaluation reports and treatment documentation to support medical necessity determinations.
Common CPT codes billed for speech therapy services include:
We document and bill using the correct codes to maximize your covered reimbursement.
Submit your insurance information and we will contact you within one business day with your coverage details.
Schedule a free consultation to discuss your child's needs.
Schedule a Free Consultationor call us at (555) 123-4567