09/11/2026
🚨 Why We Need Families & Therapists to Speak Up About the Proposed Speech Therapy Changes
Over the past several weeks, you may have seen us sharing information about proposed changes to how speech-language therapy services will be coded and valued beginning in 2027.
This can sound like an issue that only therapists or therapy practices need to worry about.
It isn't.
It has the potential to affect how many children practices can serve, how long families wait for care, and whether certain types of speech-language therapy remain financially sustainable to provide.
And right now, there is still an opportunity to speak up.
We studied what pediatric speech therapy actually looks like.
Rather than relying only on assumptions, our team at Chatterbox Pediatric Therapy conducted a time study of 157 pediatric speech-language therapy encounters.
We looked at treatment type, direct therapy time, preparation, work completed after sessions, caregiver coaching, care coordination, treatment complexity, safety needs, documentation, and other factors that contribute to the work of providing pediatric care.
What did we find?
A session averaging about 30 minutes of direct therapy actually required approximately 46 minutes of total clinician work. (Times ranged from 35-65 total minutes)
That additional time can include preparing individualized supports, reviewing a child's information, programming or modifying AAC systems, adapting treatment, educating parents, coordinating with other providers, documenting the visit, and planning what comes next.
Much of that work happens outside the time families actually see their therapist.
And nearly 1 in 2 visits involved LANGUAGE therapy.
This is the part we especially need families and clinicians to understand.
In our time study, language-only treatment was the most frequently represented treatment area, appearing in nearly half of the encounters we analyzed.
Language therapy may help a child understand what others are saying, communicate wants and needs, express thoughts and ideas, build sentences, use AAC, participate at school, communicate with family, and connect with the people around them.
Yet under the proposed differentiated timed-code structure, the estimated Medicare payment assigned to a 30-minute language-only treatment could be approximately:
47% LOWER than the current 92507 payment benchmark.
Nearly half.
But treating a child's language disorder doesn't suddenly require 47% less clinical skill, time, preparation, decision-making or follow-up.
That is one of our greatest concerns.
Why should parents care about reimbursement?
Because eventually, reimbursement can become access.
If the resources required to provide a service remain the same while payment for that service falls dramatically, practices have to figure out how to absorb that difference.
One option could be increasing session length to make the new timed-code structure financially workable.
But that creates another problem.
At Chatterbox, a full-time SLP can currently accommodate approximately 56 scheduled visits each week using our typical 30-minute treatment model.
Moving those appointments to 45 minutes would reduce capacity to approximately 44 visits per week.
That's 12 fewer children who can have a recurring therapy spot with each full-time SLP.
Across our current staffing model, we estimate that could mean approximately 2,538 fewer speech therapy appointment slots available each year.
Those aren't just numbers on a spreadsheet.
Those are appointments for children.
Children who need help communicating. Children learning to use AAC. Children with speech sound disorders. Children with language disorders. Children whose families may already have waited months to find a provider.
CMS has listened—and that's important.
We are grateful that CMS has heard concerns from speech-language pathologists and stakeholders and that an alternative approach has been considered to address some of the pediatric-specific concerns.
Our modeling suggests that the alternative GSLPP approach would be substantially less financially disruptive to our actual treatment mix than the differentiated timed-code structure.
But there are still concerns with the proposed valuations—including whether payment adequately recognizes the professional work required to provide pediatric services.
This is why the comment period matters.
CMS's own Medicare guidance recognizes the distinction between timed and untimed therapy codes and bases reporting of timed services on the time specified by the code. The question now isn't simply whether new codes can describe our services.
The question is whether those services are being appropriately valued.
📣 This is where we need your voice.
THERAPISTS: Tell CMS what pediatric therapy actually requires. Explain the clinical reasoning, preparation, caregiver coaching, AAC programming, treatment adaptation, care coordination, documentation, and mental effort that aren't visible when someone looks only at minutes of face-to-face treatment.
And please speak specifically about language intervention. Help policymakers understand why treating language does not require substantially less professional work simply because the primary treatment domain is language.
Fellow SLPs: You may use THIS Comment Builder created by the SpeakProject to make the process easier: https://form.jotform.com/262444296214053
OTs/PTs/other Health Professionals who work alongside SLPs or serve patients who also receive Speech-Language Pathology Services, you may use THIS Comment Builder created by the SpeakProject to make the process easier:https://form.jotform.com/262519516091054
PARENTS & CAREGIVERS: You have an equally important perspective. Tell CMS what speech-language therapy has meant for your child. Share what access to a qualified SLP means to your family—and what fewer available providers, fewer appointment slots, or longer waitlists could mean.
Parents & Caregivers: You may use THIS Comment Builder created by the Speak Project to make the process easier: https://form.jotform.com/262519516091054
You don't need to understand Medicare.
You don't need to understand CPT codes.
You know what access to therapy means for your child.
And that is worth sharing.
**After submitting your comment builder form, you will receive an email with a draft of your comment formatted for submission as well as instructions for the next steps.
⏰ Comments are due September 14, 2026.
(PLEASE Don't wait until the last minute!!)
CMS confirms that the public comment period for the CY 2027 Medicare Physician Fee Schedule proposed rule closes September 14, 2026.
We strongly encourage our fellow clinicians, therapy practices, parents, caregivers, educators, and others who care about children's access to communication services to speak up.
Because this conversation is about more than codes.
It's about how we value the professional work required to help children communicate.
It's about whether pediatric practices can continue creating space for the children who need us.
And ultimately—
It's about protecting children's access to care. 💚
We will continue advocating for payment policies that recognize the true time, skill, complexity, and resources involved in pediatric speech-language therapy—and we hope you'll add your voice, too.
