American Speech-Language-Hearing Association

Medicare Reimbursement of Speech-Language Pathology Services

Speech-language pathology services under Medicare Part B have reimbursement rates established by the Medicare Physician Fee Schedule regardless of provider setting. Payment is determined by the fee associated with a specific procedure code in those settings. The fee schedule is updated annually.

Payments for outpatient therapy services are subject to a combined therapy cap for speech-language pathology and physical therapy and a separate cap for occupational therapy. An exceptions process was established that allows beneficiaries to receive medically necessary outpatient services beyond the cap.

Coding

Medicare Coding Rules

Billing & Documentation

Medicare Therapy Cap

Fraud & Abuse

Other Resources

See also: Medicare Coverage Policies

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