SpecialtiesTherapy & rehabilitation
How we see speech therapy billing.
Reviewed by the VisMed therapy & rehabilitation billing team
Most speech-language pathology treatment codes are untimed and billed once per visit regardless of duration. That simplifies unit counting but shifts the pressure to visit volume, authorization counts and evaluation coding, where the distinctions between speech, language, fluency, voice and swallowing evaluations matter and payers enforce them.
The population is heavily pediatric, paid by Medicaid plans with authorization and visit limits, and delivered in clinics, homes, schools and increasingly by telepractice, each with its own place-of-service and provider rules. Adult work adds swallowing studies and voice services with their own codes and, for instrumental assessments, technical and professional components.
VisMed codes evaluations by type from the documentation, keeps a compliance calendar per patient for plans of care and authorizations, holds Medicaid rules per state and plan, and updates telepractice conventions per payer as they change.
Where speech therapy practices lose money
The patterns we find in the aging and denial history before anything else changes.
Evaluation type billed wrong
Speech sound, language, fluency, voice and swallowing evaluations have distinct codes and some cannot be billed together. Wrong or combined codes are denied.Authorization counts and Medicaid limits
Pediatric Medicaid plans approve visits per period. Visits beyond the count are unpaid.Plan-of-care and progress documentation
Certification and progress requirements apply as in other therapies, and lapses make visits unbillable.Telepractice conventions
Place of service and modifiers for telepractice differ by payer and have changed. Wrong ones are denied.Swallowing studies and components
Instrumental swallowing assessments have technical and professional components and setting rules that are often billed incompletely.
What we do differently for speech therapy
Specialty-matched coders and a denials specialist, working inside your own system.
We code evaluations by type
We select evaluation codes from the documentation with the combination rules applied.We keep a compliance calendar per patient
Plan-of-care certification, progress notes and authorization counts are tracked per episode.We hold Medicaid and setting rules per plan
Authorization forms, visit limits, place of service and billing-provider rules are held per state and plan.We keep telepractice rules current per payer
Current place-of-service and modifier conventions are applied at charge entry and updated as they change.
What we bill
The procedure and code families your account team already works in.
Speech therapy billing, asked and answered.
What a physician-owner in this specialty asks on the first call.
Can we bill a language evaluation and a speech sound evaluation on the same day?
Payer rules and the code definitions restrict which evaluation codes may be billed together, and it depends on what was done. VisMed applies the combination rules per payer and bills what the documentation supports.
How does VisMed manage Medicaid visit limits?
VisMed tracks authorization counts and periods per patient, and sends a new request before the count is used up, with the documentation the plan expects.
Are telepractice visits paid?
By most payers, under conventions that vary and have changed. VisMed holds each plan’s current place-of-service and modifier rules and applies them automatically.
Does VisMed bill instrumental swallowing assessments?
VisMed applies the technical and professional components and setting rules according to where the study was performed and who owns the equipment.
Can VisMed bill augmentative communication device evaluations?
VisMed bills the evaluation codes by time, assembles the documentation the payer requires for the device itself, and coordinates with the DME supplier so the device authorization and the therapy claims agree.
Also in therapy & rehabilitation
Physical therapy
Timed units, KX modifiers and progress notes.
Occupational therapy
Plan-of-care certification and caps.
ABA therapy
Adaptive-behavior codes, authorization units and BCBA supervision.
Chiropractic
AT modifiers, maintenance rules and Medicare limits.
Podiatry
Routine foot-care exceptions and DME.
All specialties
The full list, in six groups
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