Is Speech Therapy Covered by Insurance? Wow! This is the topic that many of you who are currently in speech therapy are probably most interested in!

SAGE Advice Series 6: Is Speech Therapy Covered by Insurance?

As a parent of a child who has needed a variety of speech and occupational therapies, I understand what keeps you up at night!!

 Coverage for speech and language therapy can be confusing, frustrating and, in the end, pretty minimal. Let’s run through the options: 

Private Pay

This is when a client pays for therapy 100% out of their own pocket.  Therapy can add up quickly, but a fantastic SLP can help a child succeed quickly and effectively (see my previous post about Structuring Therapy for Success).

Commercial Insurance

In Network: If your speech therapy practice is In-Network with your insurance company, you are in luck!! Sometimes.  Your insurance company, and specifically your plan with that company, dictates which procedure codes and diagnosis codes are and aren’t covered.  Let’s talk more about “What to ask your insurance company” when you are looking for speech coverage next.

Out of Network (OON): OON coverage is hard to come by.  However, be sure to submit your speech therapy invoices anyways, you can often get reimbursed for a percentage.  Some important things you must have on your claims include; therapist name and NPI Number, diagnosis and procedure codes, location of services, and dates and cost for each individual session.

Medicaid: some children and families are eligible for Medicaid, which often covers speech therapy. There are many types of Medicaid, but the best coverage with the largest number of providers to choose from typically comes from SSI Medicaid, Straight Medicaid, and the Katie Beckett Deeming Waiver. If you don’t think you would qualify for Medicaid, check out the Deeming Waiver, as it is not based on income!