The Wrong Evaluation Code
CPT splits SLP evaluations by what was assessed. Billing 92523 when only speech sound production was evaluated, or 92522 when language was assessed too, leads to denials or underpayment.
Speech Therapy Billing Services in Nevada for SLP Practices and Clinics
Speech therapy billing services are the evaluation coding, authorization tracking, modifier logic and payment recovery work that turn every assessment, therapy session and swallow study into paid revenue. Nevada Medical Billing provides them for speech-language pathology (SLP) practices, pediatric therapy clinics and adult rehab programs in Las Vegas, Henderson, Reno and statewide, with a 98% first-pass clean claim rate.
You give people their voice, their words and a safe swallow. We make sure that work is paid in full.
We review 90 days of SLP claims, authorizations and remittances and show you exactly where revenue is slipping. No contract. No obligation.
- SLP billing specialists (CPC)
- HIPAA compliant with a signed BAA
- Medicare, Nevada Medicaid and commercial payers
- Works inside SimplePractice, WebPT, Fusion and ClinicNote
Where Speech Therapy
Practices Lose Revenue
Speech therapy is billed differently from almost every other outpatient service, and payers know it. These seven leaks appear in nearly every SLP billing audit we run.
Authorizations That Expire Mid-Plan
Nevada Medicaid and many commercial plans authorize a set number of visits. When sessions run past the authorization, or the billed codes do not match it, the claims deny.
A Threshold Shared With Physical Therapy
Medicare tracks speech therapy and physical therapy against one combined threshold. If your patient also sees a PT elsewhere, your claims may need KX long before your own charges add up.
Plans of Care Without a Signature
Medicare pays only under a certified plan of care, recertified at least every 90 days, with progress reports every 10 visits. One missing signature can void weeks of sessions.
Sessions Delivered by Someone Medicare Will Not Pay
Medicare does not pay for services delivered by speech-language pathology assistants. Billing them under the SLP's number creates recoupment risk.
Notes That Do Not Prove Progress
"Patient tolerated session well" will not survive review. Payers want a measurable baseline, functional goals and objective progress.
Swallow Studies and AAC Evaluations Left Unbilled
Instrumental swallow studies, aphasia assessments and AAC device evaluations are separately billable, and often missed when the claim only carries 92507.
Find out how many sessions and evaluations your claims are missing. Request your free speech therapy billing audit.
How Speech Therapy
Billing Works
Speech therapy claims pair an evaluation chosen by what was assessed with treatment codes that are mostly untimed, then add modifiers that tell the payer the care happened under an SLP plan of care.
Evaluation: 92521 (fluency), 92522 (speech sound production), 92523 (speech sound plus language) or 92524 (voice and resonance), plus 96105 for aphasia and 92610 for a clinical swallow evaluation.
Treatment: 92507 for individual speech, language, voice, communication or auditory processing treatment, billed once per day regardless of session length; 92508 for groups; 92526 for swallowing and feeding therapy.
Timed exceptions: cognitive intervention (97129, 97130) is billed in 15-minute units.
Modifiers: GN on SLP services, KX above the annual Medicare threshold.
Plan of care: certified by a physician or NPP and recertified at least every 90 days for Medicare.
PT + SLP · 2026$2,480 shared threshold
A Medicare patient recovering from a stroke receives physical therapy at one clinic and speech therapy at yours. PT charges have already reached $1,900 this year. Because PT and SLP share one $2,480 threshold in 2026, your SLP claims need the KX modifier after only $580 of speech therapy. Without KX, those claims deny automatically, even though your own charges look small.
Full-Cycle Speech
Therapy Billing Services
Nevada Medical Billing runs the whole SLP revenue cycle or the stages your practice wants to hand off, so your clinicians can stay focused on communication and swallowing outcomes.
- 01
Eligibility, Benefits and Visit Limits
We verify coverage, copays, deductibles and visit limits before the evaluation, including limits shared across PT, OT and speech, and Medicare threshold usage at other providers.
- 02
Prior Authorization Management
We request, track and renew authorizations for Nevada Medicaid and commercial plans, and warn your team before visits run out.
- 03
Plan-of-Care and Progress-Report Tracking
We track certification, recertification and 10-visit progress report dates for every Medicare patient.
- 04
SLP Coding and Charge Review
Our coders match each evaluation code to the documented assessment, apply GN and KX correctly and capture every swallow, cognitive and AAC service.
- 05
Claim Scrubbing and Submission
Claims go out within 24 to 48 hours of the signed note, after NCCI edits and payer-specific rules are checked.
- 06
Payment Posting and Underpayment Audits
We post every remittance line and compare it with the Medicare fee schedule and your contracted 92507 rate, where most of your revenue sits.
- 07
Denial Management and Appeals
Denials are traced to their root cause (authorization, plan of care, modifiers or documentation) and appealed with the therapy record.
- 08
Patient Billing and Superbills
Clear statements, payment plans and superbills for private-pay families who submit their own claims.
- 09
Credentialing for SLPs
We enroll SLPs with Medicare through PECOS, Nevada Medicaid and commercial plans through CAQH, and keep CCC-SLP and Nevada license dates current.
SLP Billing and Coding Built
for Speech-Language Pathology
Speech Therapy Code Reference
| Code | Service | Billing note |
|---|---|---|
| 92521 | Evaluation of speech fluency | Stuttering, cluttering |
| 92522 | Evaluation of speech sound production | Articulation, phonology |
| 92523 | Speech sound evaluation with language | Use only when language was assessed |
| 92524 | Voice and resonance analysis | Behavioral and qualitative |
| 96105 | Aphasia assessment | Per hour |
| 92507 / 92508 | Individual / group treatment | Untimed, once per day |
| 97129 / 97130 | Cognitive function intervention | Timed, 15-minute units |
| 92610 / 92611 / 92612 | Clinical swallow eval / modified barium swallow / FEES | Instrumental studies need payer-specific documentation |
| 92526 | Swallowing and feeding treatment | Common in pediatric feeding and adult dysphagia |
| 92607 / 92608 | Speech-generating device evaluation | First hour, each additional 30 minutes |
| 92605 / 92618 | Non-speech-generating AAC evaluation | First hour, each additional 30 minutes |
| 92609 / 92606 | Therapy with a speech-generating / non-speech-generating device | Programming and training |
Modifier and Diagnosis Logic
GN on every SLP line for Medicare and Nevada Medicaid. KX once the shared PT and SLP threshold is passed. 59 or XU only for truly distinct services that NCCI allows. ICD-10-CM codes link each claim to the treating diagnosis, such as aphasia after stroke, dysphagia by phase, or a developmental speech or language disorder.
Dysphagia
and AAC Billing
Swallowing Evaluations and Therapy
We bill clinical swallow evaluations (92610), modified barium swallow studies (92611) coordinated with the radiology claim, FEES (92612) and swallowing therapy (92526), each supported by documentation of aspiration risk and functional goals.
AAC Evaluations and Speech-Generating Devices
We bill AAC evaluations and device training, and package the SLP evaluation and report that DME suppliers need to obtain funding for speech-generating devices (HCPCS E2500 to E2512).
Medicare Compliance
for Speech Therapy
2026 KX threshold: $2,480, shared by physical therapy and speech-language pathology. Claims above it need KX and supporting documentation.
Targeted medical review: claims can be reviewed once PT and SLP services pass $3,000 for the year.
Maintenance therapy: covered when the SLP's skill is needed to keep the patient from declining, as with Parkinson's disease or ALS. We make sure the documentation explains why.
Functional reporting: retired. Motor speech and other G-codes have not been required since 2019.
Pediatric Speech Therapy
and Nevada Medicaid Billing
Most pediatric speech therapy in Nevada is funded by Nevada Medicaid, its managed care plans and Nevada Check Up. Children under 21 are covered for medically necessary therapy through EPSDT.
Nevada Medicaid Provider Type 34 Rules
Nevada Medicaid bills therapy under Provider Type 34 and Medicaid Services Manual Chapter 1700. Every therapy service except evaluations and re-evaluations needs prior authorization on form FA-7, the claim must match the approved authorization, GN is required, and the ordering provider's NPI must be enrolled with Nevada Medicaid. We handle each step before the first session.
Commercial Plans and Developmental Diagnoses
Some commercial plans exclude developmental delays that are not tied to a medical diagnosis, or cap visits each year. We check those limits before the evaluation, so families are never surprised.
Who Can Bill Speech Therapy Services
The clinician on the session decides whether the claim pays. Medicare pays SLPs who are enrolled and credentialed, and it does not pay for SLPA services at all. Some Medicaid and commercial plans recognize SLPAs or clinical fellows under specific supervision rules. We bill each session under the right provider for each payer, so your practice is never exposed to recoupment.
Credentialing, Private Pay and the Move to Insurance
Many SLP practices start as private pay and add insurance later. We credential your clinicians with Medicare, Nevada Medicaid and commercial plans, set up fee schedules and claims, and keep providing superbills and good faith estimates for families who stay private pay.
PT, OT and SLP Billing for Multidisciplinary Clinics
When speech therapy shares a roof with physical and occupational therapy, we bill all three with the right modifier (GP, GO or GN), separate plans of care, the correct Medicare threshold (PT and SLP share one, OT has its own) and visit limits that commercial plans share across disciplines.
Speech Therapy Billing
for Every Practice Type
Private SLP Practices
Solo and group practices billing Medicare, Medicaid, commercial plans and private pay.
Pediatric Therapy Clinics
Articulation, language, fluency and feeding programs funded largely by Medicaid and EPSDT.
Adult Neuro and Dysphagia Programs
Stroke, brain injury, Parkinson's and head and neck cancer rehabilitation, including instrumental swallow studies.
Multidisciplinary Rehab Groups
Combined PT, OT and SLP clinics with shared front desks and shared visit limits.
Telepractice SLPs
Virtual sessions billed with the place of service and modifiers each payer requires, rules we re-check every year.
Insurance Payers We Bill
for Nevada SLP Practices
We bill Medicare Part B through Noridian (Jurisdiction F), Medicare Advantage plans, Nevada Medicaid fee-for-service, its managed care plans and Nevada Check Up, and commercial payers including Anthem Blue Cross Blue Shield, UnitedHealthcare and Health Plan of Nevada, Aetna, Cigna, Humana, Hometown Health and Prominence Health Plan, plus TRICARE West and VA Community Care.
Speech Therapy Billing
Services Across Nevada
Las Vegas and Clark County
Las Vegas, Henderson, North Las Vegas, Summerlin, Spring Valley and Enterprise practices serving large pediatric Medicaid populations and adult neuro rehab patients.
Reno, Sparks and Northern Nevada
Reno, Sparks, Carson City, Minden and Fallon practices working with regional plans and Medicare Advantage.
Rural Nevada and Telepractice
Elko, Winnemucca, Ely and Pahrump clinicians and telepractice SLPs serving rural families, billed remotely with the same expertise.
SLP practice anywhere in Nevada? Talk to a speech therapy billing specialist at (631) 652-3106.
Call (631) 652-3106Technology and EMR
Integration
Therapy EMR Systems
SimplePractice, WebPT, Fusion Web Clinic, ClinicNote, Raintree and TheraOffice, with secure role-based access and no change to how your clinicians document.
Clearinghouse Connectivity
Waystar, Availity, Trizetto and payer portals for 837P claims, eligibility checks and 835 remittance posting.
Speech Therapy Revenue Dashboards
Collections per visit, evaluation mix, authorization expirations, KX-threshold patients, denial rate by payer and days in A/R, updated daily and reviewed with you each month.
How Our Speech Therapy
Billing Process Works
Free speech therapy billing audit
We review 90 days of claims, authorizations and remittances, and quantify the revenue you are missing.
Custom plan and BAA
You choose full-cycle billing or targeted services. We sign the BAA and set up role-based access.
Payer and rules setup
We load your fee schedules, contracts, authorization rules and threshold tracking.
Parallel launch
Our team works alongside your current billing for two weeks, so no session falls through the handoff.
Backlog recovery
Unbilled sessions, aged A/R, authorization denials and underpayments are worked by dollar value and filing deadline.
Ongoing performance reviews
Monthly KPI reviews, documentation feedback and annual updates for every CPT and Medicare change.
Speech Therapy Billing
Results You Can Measure
What Nevada SLP practices see in the first 90 days: In days 1 to 30, authorization and plan-of-care tracking go live and unbilled sessions are cleared. In days 31 to 60, evaluation coding fixes, appeals and missed swallow and AAC services start returning cash. By day 90, authorization denials are falling and collections per visit are rising.
Outsourced Speech Therapy
Billing vs In-House Billing
| Factor | In-house billing or software only | Nevada Medical Billing |
|---|---|---|
| SLP-specific coding knowledge | Depends on one person or a software prompt | Coders trained on SLP evaluations, swallowing and AAC |
| Authorizations and plans of care | Tracked by hand | Automated alerts before anything lapses |
| Shared PT and SLP threshold | Rarely checked | Verified at intake and applied on every claim |
| Denials and appeals | Left in the queue | Worked to payment |
| Cost structure | Staff time, software fees and training | One fee tied to collections |
See what outsourcing would change for your practice. Book your free speech therapy billing audit.
Flexible Pricing for Speech
Therapy Billing Services
You pay for results. We price each engagement around visit volume, payer mix and services needed, and quote after reviewing your actual claims.
Percentage of Collections
The most common model for therapy practices. Our fee is a share of net collections, so we grow only when your practice does. Across the industry, outsourced therapy billing typically runs between 4% and 8% of net collections.
Per-Visit Pricing
A fixed fee per billed visit suits high-volume practices with a stable payer mix.
Targeted Services
Keep billing in-house and outsource only authorizations, credentialing, A/R cleanup or denial management.
HIPAA compliant · No obligation
Speech Therapy
Billing FAQs
Can't find what you need? Our Nevada team answers every question before you commit.
Speech therapy billing services manage the revenue cycle for SLP practices: eligibility and authorizations, evaluation and treatment coding, GN and KX modifiers, claim submission, payment posting, denial management, patient billing and credentialing.
92521 for fluency, 92522 for speech sound production, 92523 for speech sound production with language, and 92524 for voice and resonance. 96105 covers aphasia assessment and 92610 a clinical swallow evaluation.
No. 92507 is billed once per day regardless of session length. Cognitive intervention codes 97129 and 97130 are timed in 15-minute units.
$2,480, shared by physical therapy and speech-language pathology. Claims above it need the KX modifier, and services above $3,000 can face targeted medical review.
GN tells the payer the service was delivered under a speech-language pathology plan of care. Medicare and Nevada Medicaid require it on SLP claims.
Yes. Apart from evaluations and re-evaluations, speech therapy billed under Provider Type 34 needs prior authorization, and the claim must match the approved authorization.
No. Medicare does not pay for SLPA services. Some Medicaid and commercial plans do, under their own supervision rules.
Yes. We bill all three with the right modifiers, plans of care, thresholds and shared visit limits.
Most practices pay a percentage of net collections, typically 4% to 8% across the industry. We quote after the free audit, based on your visit volume and payer mix.
Most practices go live in about 30 days, including EMR access, payer setup and a two-week parallel launch.
Reviewed by the Nevada Medical Billing Therapy Billing Team (CPC certified coders specializing in PT, OT and SLP). Last updated October 2026.
Get Your Free Speech
Therapy Billing Audit
Every word a child finds and every safe swallow an adult regains starts with your work. Let us make sure your practice is paid for it. In 30 minutes, we will show you the evaluations, authorizations and sessions missing from your claims and the underpayments still worth recovering.
HIPAA compliant · No obligation · Response within one business day · Prefer to talk? Call (631) 652-3106