Will My Insurance Pay for Speech Therapy?

Obtaining insurance coverage for your child’s speech/language therapy services can be frustrating and confusing. Dealing with insurance companies first requires learning the lingo: deductibles, co-pays, co-insurance, in-network, out-of-network, ICD-9 codes, CPT codes, and the list goes on. What is most confusing for many families is that your plan benefits will almost certainly include speech therapy, yet your child’s speech therapy may not be covered. Nearly every plan includes speech therapy benefits, but there are typically restrictions on what they cover. Billing your insurance carrier is done by submitting codes for both the diagnosis of your child and the procedure. If your child’s diagnostic code is on their list of exclusions, you are out of luck. For instance, some plans only cover “rehabilitative” speech therapy, or therapy to restore lost speech or language skills as in the case of stroke or head injury. Other plans will cover speech therapy only when there is a corresponding medical diagnosis such as autism. ┬áMany plans will not cover developmental delays or non-medical speech or language disorders. New York-based speech-language pathologist, Adrienne Frohlich, has created a great list of questions to ask your insurance carrier: Speech-Therapy and Insurance Coverage-Top 10 Questions to Ask.