Speech Therapy Billing Services

Evaluation and treatment coding, benefit exclusions, school and early-intervention billing.

Speech-language pathology has the most benefit exclusions of the three therapy disciplines, and that is where the money goes. Many commercial plans exclude paediatric speech outright. Developmental delay is covered by some payers and not others. School-based work is often contracted and paid outside the medical benefit altogether. Our speech therapy billing services check the benefit before the course of care starts.

The coding itself is mostly untimed evaluation and treatment codes with the GN modifier. But swallowing studies, device programming and group therapy each follow their own rules and their own frequency limits.

Our Services

Good Billing Pays for Itself

Your practice treats people with speech disorders, and it deserves billing of the same standard. Good billing means more revenue, happier patients who stay, and a calmer place to work.

Doing that yourself alongside clinical work is a lot, which is why the billing team matters. Building one takes time and money. The choice is yours: build your own, or hand your speech therapy billing services to us. We are ready when you are.

What benefits are provided by our Speech-language Pathologists' Medical Billing Services?

  • Revenue Cycle Management

    Outsourcing billing comes down to one thing: running the revenue cycle well. That is what we focus on. We keep working a claim until it pays, and we do not give up on the difficult ones.

    Excellent Compliance

  • Excellent Compliance

    It is a rarity among several billing companies, as quality compliance necessitates attention to detailing. If not for this factor, what else could have propelled us to the summit of excellence in speech pathology billing services quality? You know the answer.

    Procedures icon

Procedures

Medical coding and billing for each category of speech-language pathology, with an equally adept expertise:

  • Cognitive-Communication
  • Treating Adult Aphasia
  • Social Communication & Pragmatics
  • Improving Overall Literacy
  • Language Development Problems
  • Treating Speech Apraxia & Dysarthria
  • Articulating Speech Sounds
  • Fluency & Stuttering Treatment
  • Feeding & Swallowing Problems Related to Dysphagia

How speech therapy claims are built

Speech language pathology has a small code set, and almost all of its denials come from a handful of predictable places.

Evaluations are code specific

There is not one evaluation code. There are separate codes for fluency, for speech sound production, for speech sound production combined with language, and for behavioural and qualitative analysis of voice and resonance. The code has to match what was actually assessed. Using one familiar evaluation code for every patient is the pattern we find most often. It shows up in a claims report within minutes.

Treatment and dysphagia

Individual treatment for a speech, language, voice or communication disorder is one code and it is untimed, which means one unit per session however long the session runs. Swallowing treatment is a different code. Billing dysphagia work under the general treatment code, or billing both without documentation supporting two distinct services, both cause recoupments.

The therapy threshold applies here too

Speech language pathology shares an annual threshold with physical therapy under Medicare. Once a patient passes it, continued treatment needs the KX modifier and documentation that shows why it remains medically necessary. Practices that treat speech as separate from the therapy threshold get a surprise part way through the year, usually for patients receiving both services.

Plan of care and progress

The same certification rules apply as for other therapy disciplines. The plan needs measurable goals, the frequency and the duration, and it needs recertifying on schedule. Progress has to be documented in terms a reviewer can measure. Statements that a patient is improving, without the measure that shows it, do not support continued treatment on appeal.

Schools, early intervention and clinics

The same clinician doing the same work is billed under different rules, depending on where it happens and who pays. Early intervention and school services often run through a state programme, not the family's insurance. Bill the wrong one first and it takes months to unpick.

Speech-Language Pathology Credentialing

SLPs face the most varied payer rules of the three therapy disciplines. It is worth checking the benefit before you spend 120 days joining a network. Paediatric speech is a common exclusion on commercial plans. School-based and early-intervention work is often contracted and paid outside the medical benefit altogether. And some payers want the Certificate of Clinical Competence (CCC-SLP), not just the state license.

We check the benefit and the credential requirement payer by payer before filing. See physical therapy, OT and speech credentialing services.