This Is About More Than a Billing Code. It is About Access to Speech Therapy.
As the owner of a pediatric therapy practice, and as a therapist myself, I have spent many years watching children walk through our doors with incredible potential, but also with very real challenges that affect their ability to communicate, learn, participate, and connect with the people around them.
I have also had the privilege of watching what happens when those children receive the right services at the right time.
I have watched a child find their voice.
I have watched a parent hear a word they have waited months, sometimes years, to hear.
I have watched children learn to tell someone what they want, what hurts, what they are afraid of, or simply what happened at school that day.
Those moments are why upcoming changes to speech therapy coding matter so much to me.
Beginning January 1, 2027, the primary billing code currently used for individual speech and language therapy, CPT 92507, will be replaced by several new codes. These codes will more specifically identify the type of treatment being provided and will incorporate treatment time into the coding structure.
On the surface, this may sound like an administrative change that families should not have to worry about.
I wish it were that simple.
Why I Am Concerned
There are aspects of the new coding system that could be positive. Speech therapy is complex, and having codes that more accurately describe the services our speech language pathologists provide may be a good thing.
My concern is not simply that the codes are changing.
My concern is how insurance companies and Medicaid programs will choose to reimburse those codes.
We do not yet have all of those answers.
If reimbursement appropriately reflects the skill, time, training, and resources required to provide pediatric speech therapy, this transition may ultimately be manageable.
If it does not, we have a much bigger problem.
Because reimbursement cuts do not just affect therapy practices.
Eventually, they affect access.
What Families May Not See Behind a Therapy Session
When you bring your child to speech therapy, you see the therapist working directly with your child. What you may not always see is everything required to make that session possible.
There is preparation before the visit. There is documentation afterward. There are treatment plans, progress reports, evaluations, insurance requirements, communication with families, collaboration with other professionals, continuing education, materials, equipment, technology, billing staff, administrative support, and countless other responsibilities involved in providing quality care.
Most importantly, there is a highly trained professional sitting across from your child who has dedicated years to learning how to help children communicate.
That expertise matters.
Speech therapy is not simply playing games or practicing words for thirty minutes.
The play has a purpose.
The activities have a purpose.
The repetition has a purpose.
The therapist is constantly watching, adjusting, challenging, supporting, and figuring out how to help that particular child make progress.
That is skilled therapy.
Early Intervention Matters
After spending my career in pediatrics, there is one thing I believe deeply: we cannot get childhood back.
There are critical periods in a child's development when their brain is growing, learning, and forming connections at an incredible rate.
When a child is struggling to communicate, waiting six months or a year for services is not insignificant.
Early intervention can help a child learn to express wants and needs, understand language, develop speech sounds, communicate with family members, interact with peers, participate in school, build confidence, and reduce the frustration that often comes when a child cannot make themselves understood.
It also teaches parents how to support communication throughout everyday life.
That is why access matters so much.
When Reimbursement Falls, Access Can Fall With It
Families sometimes hear the words "insurance reimbursement" and understandably think that is an issue between providers and insurance companies.
But there is a direct connection between reimbursement and access to care.
A pediatric therapy practice cannot continue providing a service indefinitely if the reimbursement for that service does not cover the cost of providing it.
That is not unique to therapy. It is simply reality.
Practices still have to employ qualified therapists. They have to provide appropriate treatment spaces, materials, equipment, technology, administrative support, billing support, insurance, training, and everything else necessary to safely and effectively care for children.
When reimbursement becomes unsustainable, practices are eventually forced to make choices.
Some may stop accepting certain insurance plans.
Some may limit the number of children they can serve.
Some may struggle to recruit or retain therapists.
Some programs may disappear altogether.
And when that happens, the impact does not stay within the walls of a therapy practice.
It shows up on waiting lists.
It shows up when a parent calls ten practices and cannot find one that accepts their child's insurance.
It shows up when a child qualifies for therapy but has nowhere to receive it.
It shows up when families have to drive farther, wait longer, or pay privately for services they cannot afford.
That is why this matters.
Why I Believe We Have to Speak Up
I have never believed that every change in health care is bad, and I certainly understand the need for accountability, appropriate utilization, and responsible spending.
But we also have to be willing to speak up when decisions could unintentionally make it harder for children to receive medically necessary care.
Advocacy is not about asking insurance companies to write blank checks.
It is about asking them to recognize the true value and cost of providing skilled pediatric therapy.
It is about making sure reimbursement decisions do not create an environment where fewer providers can afford to serve children who depend on Medicaid or insurance coverage.
And it is about reminding decision makers that behind every code and every claim is a child.
Parents Have an Important Voice in This Conversation
As providers, we can share numbers. We can explain staffing costs, reimbursement rates, documentation requirements, clinical standards, and treatment outcomes.
But parents can tell the part of the story that numbers never will.
You can explain what it meant when your child finally asked for something instead of crying because you could not understand.
You can explain what happened when your child became confident enough to speak in the classroom.
You can explain what it meant to finally hear "Mommy," "Daddy," "I love you," or even a simple "help me."
You can explain the difference therapy has made in your child's life and in your family's life.
Those stories matter.
We Will Continue to Advocate
There is still much we do not know about exactly how these coding changes will affect reimbursement beginning in 2027. I do not believe in frightening families with predictions when we do not yet have all of the information.
But I do believe in education.
I believe in preparation.
And I strongly believe in advocacy.
We will continue asking questions. We will continue communicating with insurance companies and Medicaid plans. We will continue educating our families as information becomes available.
And we will continue advocating for reimbursement that allows pediatric therapy providers to remain available to the children who need us.
Because after all these years of working with children, I know the value of these services firsthand.
I know how critical early intervention can be.
I know how hard families fight to get their children the help they need.
And I know that once access to pediatric therapy disappears from a community, it is incredibly difficult to rebuild.
This is bigger than CPT codes.
This is bigger than insurance reimbursement.
This is about protecting children's access to care during some of the most important years of their lives.
And that is something worth speaking up for.