Understanding and navigating reimbursement for out-of-network therapy isn't usually easy, much less straight forward. Below is information about private-pay speech-language therapy and how clients can work with their insurance companies to receive coverage, if available.
Let’s Connect is a private-pay speech-language therapy practice, which means that it is considered an out-of-network service provider not affiliated with any insurance companies.
Coverage and Benefits
If interested in filing for reimbursement with an insurance company, I advise all families to research the details of their coverage for an initial evaluation and treatment sessions ahead of time. Inquiring about deductible requirements, reimbursement rates, and copays for out-of-network services will help parents better understand their plan benefits.
Insurance companies may ask parents to provide billing codes in order to determine their child’s coverage and reimbursement. The following codes are commonly used by Let’s Connect:
- The CPT code (Current Procedural Terminology) for an individual session of speech-language therapy is 92507.
- The CPT code for a group session speech-language therapy is 92508.
- The CPT code for an evaluation of speech production (e.g., articulation, phonological processes, apraxia, dysarthria) is 92522.
- The CPT code for an evaluation of both speech sound production AND language comprehension and expression (e.g., receptive and expressive language) is 92523.
- The CPT code for an evaluation of speech fluency (e.g., stuttering, cluttering) is 92521.
Payment is due at the time of speech-language service or within 3 days of delivery. It should be made to Let’s Connect directly, and types of accepted payment include:
- Personal or bank check made out to Let’s Connect
- Credit card payments via IvyPay (HIPPA-Secure Payment System)
While Let’s Connect does not serve as a liaison between clients and insurance companies, a monthly statement (“superbill” or “paid invoice”) can be provided to families by Let's Connect at their request. This superbill can be submitted to insurance companies for reimbursement.
- Johanna Sims, M.S., CCC-SLP