09/05/2026
⚠️ Long Post Alert ⚠️
For months, I have been quietly crunching numbers, reading everything I can find, having difficult conversations, and losing more sleep than I would like to admit. As the owner of Foundations Pediatric Therapy, I feel a tremendous responsibility—not only to our clinic and our incredible team, but also to every child and family who depends on us.
Now, I need your help.
Beginning January 1, 2027, CMS is restructuring how speech-language therapy is billed and reimbursed. Early projections show potential reimbursement cuts of 25–40% for speech-language pathology services.
This is not a typical annual adjustment. A reduction of this size could be devastating to the field of speech therapy.
Imagine walking into work tomorrow and being told that your pay had been cut by 40%—not because of your performance or the quality of your work, but simply because the numbers changed. Speech-language pathologists complete years of education, clinical training, and certification to perform work that is both highly skilled and incredibly meaningful. They help children learn to communicate their wants and needs, connect with others, participate in school, eat safely, and become more independent.
At Foundations, our speech therapists pour their hearts into the children they serve every single day. I see their dedication, their expertise, and the difference they make in the lives of our families. The thought that their work could suddenly be valued so much less is heartbreaking.
And this is not only a Foundations issue—or even just a Medicare issue. Medicare rates often influence the reimbursement schedules used by Medicaid and commercial insurance companies. When Medicare makes a significant cut, the effects can spread throughout the entire healthcare system, affecting private practices, outpatient clinics, hospitals, schools, and early intervention programs.
Why right now matters:
These changes are not final yet. CMS is expected to finalize the rule in November, which means we have only a short window to show that these services—and the children and families who depend on them—are worth protecting.
Once the rule is finalized, we will be left to adapt to whatever is decided. Right now, we still have an opportunity to speak up.
I also want to be honest about what cuts of this size could mean for Foundations. They could affect how clinics like ours schedule and staff, the insurance plans we are able to accept, the length or structure of therapy sessions, and our ability to recruit and retain highly qualified therapists.
I have been working behind the scenes to understand these changes and prepare Foundations for every possibility. We are committed to continuing to show up for our children and families, just as we always have. But I also do not want to wait until decisions are finalized to tell you that this is happening.
My greatest concern extends far beyond our clinic. I worry about the child sitting on a waitlist in a community with only one pediatric speech therapist. I worry about the family whose insurance coverage is the only reason they can afford therapy. I worry about talented therapists leaving the profession because clinics can no longer afford to pay them what they deserve. I worry about longer waitlists, fewer available providers, reduced services, and clinics being forced to close their doors.
The families with the fewest options will be affected first—and the most.
How you can help:
You do not need to understand healthcare policy or reimbursement. If you are a parent whose child has benefited from speech therapy, your experience is exactly what decision-makers need to hear. Providers advocate for these services every day, but the voice of a parent or family member carries a different kind of weight.
There are two ways you can help, and either one—or both—can make a difference:
🗣️ Submit a public comment:
https://form.jotform.com/262386270505154
Share how speech therapy has impacted your child and your family. You can also explain what it would mean if your child’s access to these services were reduced or taken away. The form is simple and should take fewer than five minutes to complete.
💙 Donate to the FixSLP SPEAK Project:
https://givebutter.com/speakproject
Through this project, practice owners across the country—including Foundations—are contributing information to a shared database that reflects the true cost of providing speech therapy services. Building a strong, credible case and presenting it to CMS requires experienced legal and accounting professionals. Donations help fund that work. I have already made my personal donation because I believe deeply in this effort.
Every comment will be collected and submitted to CMS as part of the public record. One comment may feel small, but thousands of parents, therapists, educators, and community members saying, “Access to speech therapy matters,” can be incredibly powerful.
Please do not assume someone else will speak up or that there will be another opportunity after the rule is finalized. This is the time for us to use our voices.
If Foundations Pediatric Therapy has ever made a difference for your child or your family, please help us advocate for the future of these services—not only for the children we serve today, but also for every child who will need us tomorrow.
Thank you for trusting me and the Foundations team with your children. It is a responsibility and privilege that I will never take lightly.
With so much gratitude,
Kristin
Owner, Foundations Pediatric Therapy 💙💛❤️
Help fund a nationwide SLP cost survey to provide CMS with real cost data and support SLP reimbursement, CPT code valuation, and payment advocacy.
