Private speech-language pathology practices
We manage the full revenue cycle for SLPs in private practice, from credentialing and eligibility checks to claims, payments and patient balances.
Speech therapy billing & RCM · California
Speech Therapy Billing Services in California
California Billing Services provides speech therapy billing services for speech-language pathologists, pediatric speech clinics and multidisciplinary therapy practices across California. Evaluations, treatment sessions and swallowing services are coded against the note, GN and KX modifiers are applied where they belong, and plans of care and authorizations are tracked so sessions do not outrun an approval.
Talk with our team about recent speech therapy claims to see where revenue may be slipping away. Please do not send patient information through the inquiry form.
HIPAA-conscious workflowsSpeech-language pathology billing focusMedicare, Medi-Cal, regional center and commercial payersBilling from your therapy EMR
0
Untimed treatment code, billed once per session
$0,0
2026 combined Medicare PT and speech threshold
GN
Modifier on every Medicare speech therapy line
<0
Age covered by Medi-Cal for Kids and Teens
How it works
How billing for speech therapy services works
Speech therapy is billed differently from physical and occupational therapy. The core treatment code, 92507, is untimed, so it's billed once per session whether the session lasts 30 minutes or an hour. Evaluations are chosen by what was assessed: fluency, speech sound production, language, voice or swallowing. And for Medicare, speech therapy shares one annual threshold with physical therapy.
That shared threshold catches many practices off guard. A Medicare patient who has already received $2,000 of physical therapy this year starts speech therapy for dysphagia after a stroke. After a few sessions, the combined total passes the 2026 threshold of $2,480. Every speech claim from that point needs the KX modifier, even though the speech therapy itself has barely begun. Without it, the claims deny.
Shared Medicare threshold example
- PT already billed this year
- $2,000
- 2026 combined PT + speech threshold
- $2,480
- Remaining before KX
- $480
- Speech claims after threshold
- GN + KX
Who we serve
SLP billing services for every California speech therapy practice
California Billing Services sets up billing around the patients you treat and the payers who cover them.
Pediatric speech therapy clinics
We bill articulation, language, fluency and feeding therapy to Medi-Cal plans, commercial insurers and regional centers, and we track the authorizations and visit limits each one sets.
Adult neuro and dysphagia specialists
We bill aphasia, dysarthria, cognitive-communication and swallowing services for adults recovering from stroke, brain injury and neurological disease, including clinical and instrumental swallowing evaluations.
Multidisciplinary therapy practices
For practices offering speech alongside physical and occupational therapy, we track each discipline's modifier, the shared Medicare threshold and shared commercial visit limits.
Teletherapy providers
We bill speech teletherapy with the place-of-service codes and modifiers each payer requires, and we confirm current telehealth coverage before sessions are billed.
School and early intervention contractors
We bill speech services provided under contracts with school districts, regional centers and Early Start programs, each with its own billing and authorization rules.
Where revenue leaks
Where speech therapy practices lose revenue
Speech therapy revenue rarely disappears in one large denial. It slips away one session, one modifier and one expired authorization at a time. These are the problems we find most often.
92507 billed in units
Billing the untimed treatment code as multiple 15-minute units, which leads to denials and repayment demands.
Wrong evaluation code
Billing 92522 and 92523 together, or choosing an evaluation that doesn't match what was assessed.
Missed KX on shared thresholds
Not counting a patient's physical therapy toward the combined Medicare threshold.
Same-day swallowing and speech treatment
Billing 92526 with 92507 without separate documentation and the modifier needed to pay both.
Unspecified diagnoses
Using broad codes such as unspecified dysphagia when the note supports a specific phase or cause.
Assistant services billed to Medicare
Billing SLPA services that Medicare doesn't pay.
Expired authorizations and plans of care
Sessions billed after approvals or certifications lapse.
Medical coding
Speech-language pathology billing and coding services
California Billing Services codes from the SLP's evaluation, daily note and plan of care, so every claim reflects what was assessed and treated.
Speech and language evaluations
We bill fluency evaluations (92521), speech sound evaluations (92522), combined speech sound and language evaluations (92523) and voice evaluations (92524), choosing the code that matches what the SLP assessed and never pairing 92522 with 92523.
Speech, language and voice treatment
We bill individual treatment with 92507 and group treatment with 92508 once per session, unless a specific payer requires a different unit rule.
Swallowing and dysphagia services
We bill clinical swallowing evaluations (92610), video fluoroscopic swallow studies (92611), endoscopic swallowing evaluations (92612-92617) and swallowing treatment (92526). When swallowing and speech treatment happen on the same day, we bill both only when the note documents each separately.
Cognitive-communication and aphasia services
We bill aphasia assessment (96105), standardized cognitive testing (96125) and cognitive function intervention (97129 and 97130) for adults with brain injury, stroke and dementia.
AAC and speech-generating device services
We bill augmentative and alternative communication evaluations (92605, 92607, 92608 and 92618) and device training (92606 and 92609), and we support the documentation payers require before approving a speech-generating device.
Modifiers and diagnosis coding
Every speech therapy line billed to Medicare carries the GN modifier, and KX is added once the combined PT and speech threshold is reached. We code diagnoses to the highest specificity the note supports, such as F80.2 for mixed receptive-expressive language disorder or I69.320 for aphasia after stroke.
Built around the SLP note
From Session Note to Supported Claim
Evaluations, treatment and swallowing services are coded from what the SLP assessed and documented in each session.
Full revenue cycle
Speech therapy medical billing from referral to payment
California Billing Services manages the complete revenue cycle for billing speech therapy services, from the referral to the final payment. Choose end-to-end billing or only the services your practice needs.
Insurance eligibility and therapy benefits verification
We verify coverage before the first session, including speech therapy visit limits, habilitative and rehabilitative benefits, the patient's remaining Medicare threshold and whether speech shares a limit with PT or OT.
Explore servicePrior authorization and session tracking
We request authorizations from health plans, Medi-Cal and regional centers, track approved sessions and dates, and request extensions before they run out.
Explore servicePlan of care and certification tracking
We track every plan of care, certification, 90-day recertification and 10-visit progress report, and alert your team before a deadline is missed.
Charge entry and claim scrubbing
We reconcile sessions in your EMR against billed charges, then check each claim for evaluation pairing, untimed code units, modifiers, NCCI edits and payer rules before submission.
Explore servicePayment posting and underpayment recovery
We post payments line by line, compare them with your contracted rates and fee schedules, and appeal underpaid claims instead of writing them off.
Denial management and appeals
We sort denials by root cause, such as medical necessity, missing authorization, expired plans of care or diagnosis specificity, fix the source and appeal with the SLP's documentation.
Explore serviceAccounts receivable follow-up
We work open claims by balance and age, and we can take over aged AR from your previous billing company during the transition.
Explore serviceCredentialing and payer enrollment
We enroll SLPs with Medicare through PECOS, Medi-Cal through PAVE and commercial plans through CAQH, and we confirm each payer's rules for clinicians practicing under an RPE temporary license.
Explore servicePatient and family billing
We send clear statements to patients and parents, answer billing calls and set up payment plans for copays, deductibles and sessions beyond a plan's limit.
Reporting and analytics
Monthly reporting covers collections by SLP, payer and code, plus sessions per authorization, denial rate, days in AR and underpayments recovered.
California payers
California speech therapy billing rules we handle every day
California adds its own licensing board, children's programs and school billing on top of Medicare and commercial rules. Each one affects whether a speech therapy claim gets paid.
01
Medicare and Noridian
We bill Medicare through Noridian (Jurisdiction E), track the combined PT and speech threshold for each patient, and follow Medicare's plan of care and progress report rules.
02
Medi-Cal and Medi-Cal for Kids and Teens
We bill Medi-Cal managed care plans and fee-for-service Medi-Cal, request Treatment Authorization Requests where needed, and bill pediatric speech therapy under Medi-Cal for Kids and Teens, California's benefit for medically necessary care under age 21.
03
Regional centers and Early Start
We coordinate billing with regional centers that fund speech therapy for people with developmental disabilities, and with Early Start for children under 3. Each has its own authorization and invoicing process.
04
School-based speech therapy
We support speech services delivered in schools, including billing under contracts with school districts and the documentation districts need for the LEA Medi-Cal Billing Option Program.
05
California licensing requirements
California licenses SLPs through the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board. We confirm each clinician's license status, including RPE temporary licenses, so services are billed only under credentials the payer accepts.
Choosing a partner
How to choose a speech therapy billing company
The best speech therapy billing services understand SLP rules well enough to find revenue your current biller is missing. Ask any company you're considering these questions:
- 1Do you bill 92507 once per session or in units?
- 2How do you track the combined PT and speech Medicare threshold?
- 3How do you bill 92526 and 92507 on the same day?
- 4How do you handle SLPA services for Medicare and Medi-Cal?
- 5Do you bill regional centers and Early Start?
- 6How do you track plans of care and progress reports?
California Billing Services can walk through each of these questions using examples from your own claims.
Outsourcing speech therapy billing versus keeping it in-house
| In-house billing staff | California Billing Services | |
|---|---|---|
| SLP coding expertise | Depends on one or two hires | Team focused on speech-language pathology billing |
| Shared Medicare threshold tracking | Often missed | Tracked across PT and speech |
| Regional center and Early Start billing | Learned on the job | Built into our workflow |
| Plan of care tracking | Manual reminders | Tracked with alerts |
| Staff turnover | Billing slows or stops | Team-based coverage |
| Cost | Salaries, benefits, software and training | Quoted for your practice |
Step by step
How we take over your speech therapy billing
Agree responsibilities, access and timing before moving claims to a new billing team.
- 0
Claims review
We review recent claims, payments and authorizations and share what we find.
- 0
Setup
We put agreements in place, connect to your therapy EMR and practice management system, and set up EDI, ERA and payer enrollment.
- 0
Parallel billing
We bill new sessions while your current biller completes its open claims, so cash flow keeps moving.
- 0
Full transition
We take over all billing and begin working your aged AR.
- 0
Monthly review
You receive a performance report and a review call every month.
Results
Speech therapy billing results you can measure
Review the indicators that show how your speech therapy revenue cycle is performing, against your practice’s baseline and agreed reporting scope.
| Metric | What we report |
|---|---|
| Clean claim rate | Share of claims accepted on first submission |
| Denial rate | Denials by payer and root cause |
| Days in accounts receivable | Average time from session to payment |
| Net collection rate | Collected versus collectible revenue |
| Sessions billed after authorization expired | Sessions outside an active approval |
Compliance
Compliant, audit-ready speech therapy billing
Speech therapy draws close review from Medicare, Medi-Cal and commercial payers, especially for medical necessity, plans of care and evaluation coding. California Billing Services bills so every claim can be defended.
- Ongoing speech therapy billing training for our coding team.
- Claims checked against NCCI edits, MUE limits and Medicare therapy policy.
- Documentation feedback when a note doesn't support the service billed.
- HIPAA-conscious handling of practice and patient data.
Systems
Speech therapy billing inside the EMR you already use
We work from your therapy documentation system and your practice management system. Your SLPs keep documenting the way they do now, and we bill from the notes they already write. Confirm your specific EMR with our team.
Session-level visibility
Every Session Matched to an Approval
Plans of care, authorizations and billed sessions are tracked together so visits are not billed after an approval or certification lapses.
Pricing
Speech therapy billing pricing
Your rate depends on session volume, payer mix and the services you choose. California Billing Services provides a quote after reviewing your practice.
Locations
Speech therapy billing services across California
California Billing Services bills for speech therapy practices throughout the state, working remotely inside your systems.
Southern California
Los Angeles, Long Beach, Pasadena, Orange County, Irvine, San Diego, Riverside and San Bernardino
Bay Area and Northern California
San Francisco, Oakland, San Jose, Walnut Creek, Sacramento and Roseville
Central California
Fresno, Bakersfield, Modesto, Stockton and Visalia
See Los Angeles · San Diego · San Francisco · all locations.
Your next step
Find out what your speech therapy claims are leaving unpaid
Send us recent claims. We'll show you which sessions, codes, modifiers and authorizations are costing your practice and how we'd recover them.
FAQ
Speech therapy billing FAQs
Speech therapy billing services are the coding, claim submission and payment follow-up for evaluations and treatment provided by speech-language pathologists. They include evaluation coding, modifiers, plan of care and authorization tracking, denials and patient billing. California Billing Services provides these services for speech therapy practices across California.
Can't find what you're looking for? Contact our billing specialists