Speech Therapy Billing Services That Protect Your Per-Session Revenue

We manage the complete range of speech-language pathology CPT codes including:

• 92507 — Individual speech therapy treatment
• 92508 — Group speech therapy treatment (2+ patients)
• 92521 — Evaluation of speech fluency (e.g., stuttering)
• 92522 — Evaluation of speech sound production (articulation)
• 92523 — Evaluation of speech sound production with fluency
• 92524 — Evaluation of language (expressive/receptive)
• 92526 — Evaluation of oral and pharyngeal swallowing function
• 92597 — Evaluation for speech-generating device (SGD)
• 92607 — SGD assessment for speech generating device
• 92609 — SGD assessment, subsequent
• 92610 — SGD programming
• 96110 — Developmental screening
• 96125 — Standardized cognitive performance assessment

We follow CMS's time-based billing rules precisely. For time-based CPT codes like 92507 and 92508, the 8-minute rule dictates that you must provide at least 8 minutes of skilled therapy to bill 1 unit, at least 23 minutes for 2 units, at least 38 minutes for 3 units, and at least 53 minutes for 4 units. Our team reviews every session note to verify the documented treatment time matches the billed units. If the note says 40 minutes, we bill 3 units — not 4. If it says 52 minutes, we verify if the documentation supports rounding up to 53 minutes for 4 units. This precision protects your practice from overpayment recoupment audits while ensuring you capture every legitimate unit.

"Maintenance therapy" denials are the most common challenge in adult speech therapy — particularly for aphasia, dysphagia, and cognitive-linguistic deficits. Payers argue that the patient has plateaued and no longer requires "skilled" SLP services. We overcome these denials by structuring appeals around Medicare's definition of skilled care: the therapy must require the specialized skills of a speech-language pathologist to be performed safely and effectively, and there must be a reasonable expectation of improvement or maintenance of a functional level that would deteriorate without skilled intervention. We work with your SLPs to ensure treatment notes document the specific skilled techniques used, the patient's response, and why unskilled care (e.g., family practice) would not be sufficient.

Yes, SGD billing is one of our specialties. The process involves multiple steps and codes: 92597 (initial evaluation for SGD need), 92607 (comprehensive SGD assessment including trial with device), 92609 (subsequent assessment for programming modifications), and 92610 (SGD programming). Most payers require documentation of a trial period with the device, evidence that the patient meets specific functional communication limitations, and often a letter of medical necessity. We manage this entire workflow — tracking the trial period, coordinating between the SLP and the equipment vendor, ensuring all required documentation is in place, and following up on claims until the device is approved and paid.

They operate under completely different frameworks. School-based speech therapy is driven by the Individualized Education Program (IEP) and funded through federal and state education dollars — the goal is to help the child access their education. Medical speech therapy is driven by a physician's referral and medical necessity, funded by insurance or Medicare — the goal is to treat a diagnosed medical condition. The clinical documentation requirements, authorization processes, and coding rules are entirely different. Using IEP-style language ("helps with classroom participation") on a medical insurance claim will result in an immediate denial. We ensure that every medical claim demonstrates medical necessity with appropriate clinical terminology, regardless of whether your SLPs also work in school settings.

We ensure maximum specificity with ICD-10 codes, which is critical for both reimbursement and authorization approval. Common codes include:

• F80.0-F80.9 — Developmental speech and language disorders
• F84.0 — Autism spectrum disorder (with associated language impairment)
• R47.0 — Aphasia
• R47.1 — Dysarthria
• R13.10-R13.19 — Dysphagia, oral phase / pharyngeal phase
• R48.1 — Aphasia (specific) / R48.8 — Other symbolic dysfunction
• R48.2 — Cognitive communication deficit
• F98.5 — Stuttering
• I69.320 — Cognitive deficits following cerebral infarction
• G71.01 — Myasthenia gravis with bulbar involvement (for dysphagia)

Prior authorization is the backbone of speech therapy revenue, and we manage it proactively. Before any treatment begins, we verify whether the payer requires authorization and, if so, what documentation they need — typically a speech-language evaluation, treatment plan with goals, and physician referral. Once authorized, we track the approved number of sessions against actual sessions billed in real-time. When a patient approaches their authorized session limit, we initiate the re-authorization process automatically — submitting updated progress notes and a continued treatment plan — so there's no gap in care and no unpaid sessions. This real-time tracking is how we maintain a 92%+ authorization approval rate.

We use a transparent percentage-of-collections model — typically 5-8% depending on practice volume, payer mix, and whether you bill for complex services like SGD evaluations. SLP practices benefit enormously from this model because the revenue improvement comes from two places: capturing underbilled time units and recovering denied claims. Even correcting the 8-minute rule by just 1 additional unit per day across your caseload can offset our entire fee. There are no setup fees, no per-claim charges, and no long-term contracts. If we don't collect, you don't pay.