Toddler Talk

View Original

How much does speech therapy cost?

There are 3 different options for speech therapy, so how much you pay will depend on which option you choose.

Speech therapy costs - ranked from least expensive to most expensive

  1. Public Programs - Free (or low cost)

  2. Insurance - $35 Copay per session (varies by plan)

  3. Self Pay - $150 per session (varies by provider)


A note to all parents before we dive in:

Speech therapy is speech therapy, no matter where you get it.

Sure there will be differences based on the individual speech therapist working with your family and the setting speech therapy takes place in (either a school, clinic, or your home). But the actual speech therapy part should be pretty similar. 

If you’ve been stressing or feeling guilty because you can’t afford private speech therapy, please find something new to worry about :) Your child’s success in speech therapy is more dependent on you understanding what goals they are working on and practicing at home than it is getting private versus public speech therapy. 


Speech Therapy Cost - 3 Options

No matter which speech therapy option you choose, there are some important factors to take into consideration. Each will directly impact your overall cost of speech therapy.

  • Speech Therapy Frequency - How many sessions will you have per week. The speech therapist should share their recommendation with you at the time of your child’s evaluation and explain why they recommend that frequency. One or two times a week are the most common frequencies.

  • Speech Therapy Duration - How many months do you anticipate being in speech therapy. Your speech therapist should also tell you how many months of speech therapy they are recommending at the time of the evaluation. Your child may need more or less speech therapy, but this is a good starting place for your speech therapy budget.

In order to calculate the total speech therapy cost per month you can use this formula:

( Speech Therapy Frequency x 4.3 weeks in a months ) x Cost Per Speech Therapy Session

Public Speech Therapy Cost: (2 sessions/week x 4.3 weeks) x $0 copay = $0/month

Speech Therapy Cost with Insurance: (2 sessions/week x 4.3 weeks) x $35 copay = $310 per month

Private Speech Therapy Cost: (2 sessions/week x 4.3 weeks) x $150 copay = $1,290 per month


Now let’s dive into how you can get started with each of the speech therapy options and I’ll share a few helpful questions when considering which option is best for you at the end.

See this content in the original post

1. Public Speech Therapy (mostly free)

You can get a started either through your state’s Early Intervention Program (if children are younger than 3 years) or through the Public School System if your child is 36 months or older. 

The government will pay for your child to have a speech and language evaluation or assessment, this is no cost to you.

If at your evaluation your child meets the requirements to qualify for speech therapy, services will be covered using your public or private insurance. And “services that are not covered by insurance will be purchased or provided by regional centers or local education agencies” (Early Start CA). In sum, early intervention is always billed to the insurance you have first, and if services are not covered they the state early intervention program will cover the cost for children who qualify. 

Who qualifies for speech therapy?

In order to qualify for therapy services in CA, children birth to 36 months must meet one of these criteria:

  • have a developmental delay of at least 33% in one or more areas of cognitive, communication, social or emotional, adaptive, or physical and motor development including vision and hearing

  • have an established risk condition of known etiology, with a high probability of resulting in delayed development

  • be considered at high risk of having a substantial developmental disability due to a combination of biomedical risk factors of which are diagnosed by qualified personnel

California Government Code: Section 95014(a) California Code of Regulations: Title 17, Chapter 2, Section 52022

An important note about public speech therapy eligibility

Eligibility is not based on family income, all family have equal access to public speech therapy services. A child’s or parent’s immigration status also does not affect eligibility, everyone is eligible. There is no cost for evaluation, assessment, and service coordination. If services recommended in for your toddler are not covered by your insurance, your Regional Center will pay for them (Regional Centers are community based organizations that assist with early intervention access). 

See this content in the original post

2. Speech Therapy Cost With Insurance (like Blue Shield, BCBC, TriCare Prime, Cigna, etc.)

How do I access speech therapy through my insurance?

If you have private insurance, your child (at any age) may qualify for speech therapy paid for by your insurance. With most insurance plans you’ll have a copay your responsible for paying at every session.

In order to access speech therapy through your insurance you will need:

  • First, a referral from your child’s primary care doctor for a speech and language evaluation.

  • If at the time of the evaluation the speech therapist recommends speech therapy sessions, then the speech therapist will ask your child’s primary care doctor for a speech therapy referral.

  • This referral will be sent to your insurance company and they will either approve or deny the request. You will most likely be notified via mail or email if elected that your request has been approved. 

  • Then, you can schedule your fist speech therapy appointment.

When does insurance cover speech therapy costs for children?

Because this speech therapy is being paid for by the insurance company, there are certain circumstances in which speech therapy is most likely to be approved (in other words these are common instances in which insurance agrees to pay for speech therapy).

  1. Your child is under 3 years old and requires early intervention

  2. Your child is not yet getting school speech therapy - insurance may pay for speech therapy while you’re going through the process of getting started in school.

  3. Your child is getting speech therapy through school, but they need more support than the school is providing. This type of speech therapy is often referred to as supplemental speech therapy. This is most common when a child has a communication deficit that is not seen as impactful to their education and therefore is not included in the school speech therapy plan.

  4. If your child doesn’t meet the qualification requirements from school speech therapy, but could benefit from speech therapy nonetheless. Schools only provide services for things that they consider as impacting academic performance and they are less likely to offer help for mild communication troubles. In this case insurance should pay for some speech therapy sessions.


What does speech therapy cost with insurance?

CityWhat you would pay to see an in network providerWhat you would pay to see an out of network provider
San DiegoCopay$200
CharlotteCopay$130
New York CityCopay$250
DallasCopay$180
OmahaCopay$200
Salt Lake CityCopay$110
ChicagoCopay$200

It’s important to know that you’ll pay the least for speech therapy if you are seen by a provider who is in your network. You can search “In Network Providers” on your insurance companies website, and the speech therapist your doctor refers you to should be in-network.

When you see an in-network provider you will be charged a copay. You can see what your copay is either by looking at your insurance card or by calling your child’s insurance company to inquire.

You’ll also have a copay for your evaluation appointment, which could be a little more costly than a speech therapy session copay. Calling your child’s insurance company to inquire is to best way to get informed about all the expenses you’ll be responsible for.

Out of network providers…

To give you an idea of what speech therapy costs if your see an out of network provider, I’ve looked up the price of speech therapy in some cities across the country.

The average out of network cost for 1 speech therapy sessions is $181.

The prices I have reported are for just ONE speech therapy session. If we use our calculation for the cost of speech therapy (2 x $181) x 4.3 = $1,557 for one month of speech therapy… personally I think that’s ridiculous!!

I guess what I am trying to say is to double check that your provider is in your insurance network so you don’t get any surprise bills for speech therapy!

These are all taken from the Fair Health Consumer report. Prices may change over time, these numbers taken on November 9, 2022. 

See this content in the original post

3. Self Pay Speech Therapy Cost

There are a few reasons you may opt for self pay speech therapy. Some private practice speech therapist do no accept insurance, so self pay is the only option if you want to partner with them. In other instances you may have reached your speech therapy quota placed by your insurance company for the year (some insurance plans have a limited # of sessions they’ll pay for) or the speech therapist you want to visit is out of your insurance provider network.

Depending on where you live and your speech therapist’s rate, you’ll most likely being paying $100-$250 out of pocket for one speech therapy session.

And before you get started in speech therapy, you’ll be responsible for paying for a speech and language evaluation with your chosen provider, which is usually $250-$700.

If we use our calculation for the cost of speech therapy, this is what it may cost for self pay speech therapy for your little one:

  • $100/ session —> (2 x $100) x 4.3 = $860 for 1 month of speech therapy

  • $250/ session —> (2 x $250) x 4.3 = $2,150 for 1 month of speech therapy

This is not a realistic option for most people, because the costs can be quite significant. But it is an option for families who can fit the cost within their budget and are looking to work with a particular speech therapist.


How to know which option is right for you? 

Here are some questions that may help you decide:

  1. How much can you realistically afford to spend on speech therapy each month? Speech therapy can get expensive. Think about your family's budget and have an honest conversation with yourself or your spouse about what you can afford (It does not make you a bad parent if you can’t pay for private speech therapy!). Prioritizing your families needs and taking advantage of state speech therapy offerings (which you’re paying for in your taxes) is smart! 

    If the budget is tight, take advantage of the public speech therapy offered by your state!

  2. Does our insurance cover speech therapy? If you have private insurance, talk to your pediatrician about finding a speech therapist who is in your provider network and covered by your insurance plan. It is also a good idea to call your insurance company to see if there is a limit on the number of speech therapy sessions they will pay for per calendar year before even getting started. Some insurance plans have a specific limit or quota while others do not. Knowing this ahead of time can help you plan strategically and space out your speech therapy sessions as needed.

  3. Is there a specific reason why we need to see an out of network provider? If your budget allows, seeing a private speech therapist may make the most sense for your family, especially if you’re looking for a specialist in a particular area of speech therapy (like a stuttering specialist or a cleft palate expert). Just keep in mind that you are likely to find a specialist in that same area within your insurance network, and your insurance company should be able to assist you with that search.

Another possible option!

If there is a university in your area, you may be able to find free or low cost support in the university speech therapy clinic. Depending on the university there may be a research project you could participate in or a student clinic where graduate students work with children under the supervision of a licensed speech therapist.


Here are some other questions parents often have about the cost of speech therapy:



Written By: Stephanie Keffer, MS CCC-SLP


© 2020-2023. Stephanie Keffer, MS CCC-SLP. All Rights Reserved.

 

The content offered on ToddlerTalk.com is for informational purposes only. Toddler Talk is not engaged in rendering professional advice, whether medical or otherwise, to individual users or their children or families. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor, speech language pathologist, or other health professional. By accessing the content on ToddlerTalk.com, you acknowledge and agree that you are accepting the responsibility for your child’s health and well-being. In return for providing you with information related to home speech and language practice, you waive any claims that you or your child may have as a result of utilizing the content on ToddlerTalk.com.