Insurance & Payment
Insurance & Payment Options
We work to make therapy accessible and affordable. Our team handles the insurance details so you can focus on progress.
Insurance Plans We Accept
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.
Understanding Your Benefits
Insurance terminology can be confusing. Here's what each term means in plain language.
Deductible
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.
Copay
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.
Coinsurance
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.
Out-of-Pocket Maximum
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.
Prior Authorization
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.
How We Help With Insurance
We navigate the insurance process for you — start to finish.
We verify your benefits before your first visit
Before your appointment, we contact your insurance carrier to confirm your speech therapy coverage, deductible status, and copay amounts.
We handle pre-authorization when required
If your plan requires prior authorization, our team prepares and submits all necessary clinical documentation on your behalf.
We submit claims directly to your insurer
After each session, we file claims electronically so you receive maximum reimbursement with minimal paperwork on your end.
We provide superbills for out-of-network reimbursement
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.
In-Network vs. Out-of-Network
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 |
Does Insurance Cover Speech Therapy?
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:
- 92521Evaluation of speech fluency (e.g., stuttering)
- 92522Evaluation of speech sound production
- 92523Evaluation of speech sound production with language comprehension and expression
- 92524Behavioral and qualitative analysis of voice and resonance
- 92507Treatment of speech, language, voice, communication, and/or auditory processing disorder (individual)
We document and bill using the correct codes to maximize your covered reimbursement.
Insurance Questions
Verify Your Coverage
Submit your insurance information and we will contact you within one business day with your coverage details.
Ready to Take the First Step?
Schedule a free consultation to discuss your child's needs.
Schedule a Free Consultationor call us at (555) 123-4567