ASHA’s 2025 Payer Summit Addresses Ongoing Provider Challenges and Upcoming Payment Changes

On May 15-16, 2025, ASHA held its annual Payer Summit to discuss the state of the audiology and speech-language pathology professions, advocate on key issues, and gather information from insurers to improve our provider resources. This year, the summit focused on problems with decreasing rates, capitated rates, rising paperwork burden, coverage limitations, third-party administrators, and anticipated changes coming to Medicaid and managed care.

Attendees included representatives from private insurance and utilization management companies, state Medicaid agencies, and Medicaid managed care organizations. ASHA staff discussed coverage, coding, and payment policy issues for audiology and speech-language pathology services with payer representatives.

Continuing Conversations With Insurers

During discussions at the summit, ASHA identified different ways that we and payers can better support audiologists and speech-language pathologists. For example, we encouraged more payers to add new caregiver training codes to their fee schedules. Payers identified areas that need more supportive research and guidelines to support the changes we hope to see.

It’s vital that payers consider the financial and logistical burden placed on providers to ensure timely beneficiary access to medically necessary services. To that end, ASHA educated payers on the purpose and importance of covering the new caregiver training codes, anticipated changes to Medicaid and managed care, ongoing issues with third-party administrators, audiological treatment services, telehealth, same-day services, and other areas with limited coverage. The summit addressed the impact of burdensome prior authorization requirements and unnecessary denials on providers and patients. We also discussed the challenges and potential of payment innovation through value-based care and artificial intelligence.

Attendees also shared future innovations being considered across the payment space. Together, we identified opportunities for ASHA and attendees to improve provider training, resources, and other supports that can help providers navigate the payment world, such as tips on documentation for insurance, responding to denials, and drafting appeals.

What’s Next

ASHA continues to develop resources based on these discussions and to urge attendees to make necessary changes to improve the provider and patient experience. We will also continue our work to engage with attendees to share guidance, research, and data to support our advocacy on member pain points, such as limited coverage, burdensome prior authorization, and reimbursement rates.

Why the Payer Summit Matters

The Payer Summit was created in 2019 to forge relationships between health insurance payers and ASHA staff to share information directly from ASHA members in the field. The Payer Summit agenda is built on the issues and questions shared by ASHA members and policy issues identified by ASHA staff. ASHA gathers information from member committees, state-based advocacy networks, and individuals through conversations, emails, social media, meetings, and surveys. This spring, ASHA circulated a Payer Summit feedback form through social media and community channels.

Building and strengthening these connections provides ASHA staff with contacts at payers to better address member needs. For example:

• Connections made at previous summits recently led to discussions to address problematic prior authorization practices, hearing aid coverage parameters, and school-based Medicaid payment policies.
• After last year’s summit, more payers adopted coverage of the new caregiver training codes.
• Last year’s summit generated discussions with a couple of different payers on the nuances of value-based care and guidance on implementing quality measures and incentives.
• Since this year’s summit a few weeks ago, attendees have expressed interest in continuing their engagement with ASHA to help facilitate some of the changes discussed at the summit.

Questions?

For questions, please contact ASHA’s health care and education policy team at reimbursement@asha.org.