We are in network with most Blue Cross plans
We are pleased to bill your Blue Cross plan for you; we are in network with most Blue Cross plans, such as Anthem and CareFirst. Your cost and coverage will vary depending on your plan.
Keep in mind that Blue Cross determines your coverage, exclusions, denials, copay/coinsurance amounts, visit amount caps, and processing times, which affect what and when you pay. We do what we can to get them to cover therapy, but keep in mind that your well-being is not your insurance company's priority. We routine request more visits than plans specify, hoping they will approve more coverage based on the individual's needs.
You are responsible for all costs that insurance does not cover. Note that medical insurance never covers education-related services, such as IEP reviews, teacher conferences, and IEP meetings.
All sessions billed to insurance are 30 minutes in length.
Keep in mind that Blue Cross determines your coverage, exclusions, denials, copay/coinsurance amounts, visit amount caps, and processing times, which affect what and when you pay. We do what we can to get them to cover therapy, but keep in mind that your well-being is not your insurance company's priority. We routine request more visits than plans specify, hoping they will approve more coverage based on the individual's needs.
You are responsible for all costs that insurance does not cover. Note that medical insurance never covers education-related services, such as IEP reviews, teacher conferences, and IEP meetings.
All sessions billed to insurance are 30 minutes in length.
Costs for Private Pay Speech Therapy
Therapy sessions for children are typically 30 minutes long, at a cost of $79 per session. Thirty minutes seems to be the sweet spot for attention and participation. Occasionally children are able to participate meaningfully for 45 minutes, in which case the parent can request a 45-minute therapy session at $119 per session.
Therapy sessions for older teens and adults are either 45 minutes long at a cost of $119 per session or 30 minutes at a cost of $79 per session.
All private pay intake appointments cost $229 for a 45-minute appointment. Pediatric intakes include a parent conference during this time to explain what is going on and come up with a plan. If you would like formal testing or reports, the cost is based on the amount of time the clinical spends working.
Other work is priced as follows:
-$200 flat rate for IEP meeting attendance
-$50 Educational document review
-$40 per started quarter hour for all other work, including written reports/feedback, parent meetings, teacher meetings, educational advocacy outside of regular IEP meetings, and standardized testing
Therapy sessions for older teens and adults are either 45 minutes long at a cost of $119 per session or 30 minutes at a cost of $79 per session.
All private pay intake appointments cost $229 for a 45-minute appointment. Pediatric intakes include a parent conference during this time to explain what is going on and come up with a plan. If you would like formal testing or reports, the cost is based on the amount of time the clinical spends working.
Other work is priced as follows:
-$200 flat rate for IEP meeting attendance
-$50 Educational document review
-$40 per started quarter hour for all other work, including written reports/feedback, parent meetings, teacher meetings, educational advocacy outside of regular IEP meetings, and standardized testing
We are out-of-network, private-pay providers with most insurance companies. Why?
- Efficacy: Out-of-network providers are motivated to provide a higher level of service, which means faster progress for you. This results in less therapy visits overall and a higher level of achievement.
- Independence: Insurance companies limit the number of sessions an individual can have and what can be worked on in therapy. We don't believe insurance companies should have the right to restrict the intervention a person receives.
- Privacy: We are not obligated to share anything about diagnosis and treatment with your insurance company, school, or anyone else.
- Freedom: We have the freedom to provide service not only when an individual is behind, but also to get them ahead.
Your non-Blue Cross insurance may still cover services,
and it may be cheaper than seeing an in-network provider.
We encourage you to check whether your private insurance has out of network benefits. This is often the case with PPO plans.
Here is how it works to use out-of-network insurance benefits:
1. You pay the therapy cost (typically $79). This is done by automatically charging your card each time you have an appointment.
2. We provide superbills and invoices on the 10th of each month for the previous month.
3. You provide the superbills to your insurance company, as instructed by them.
4. They pay you the amount corresponding to your insurance plan. Only your insurance company can determine this, and you have the right to ask them.
Our clients find that what we do is so effective that it’s well worth the extra step of submitting for reimbursement. Most are paying less than they would for an in-network provider.
Example of a client switching from an in-network provider to an out-of-network provider and saving money:
The client has a $30 copay for speech therapy and 30 visits allowed per year. This is a common speech therapy benefit through a good insurance plan. Total cost of 50 sessions (i.e., 1x weekly for a year) for services costing $30 for the first 30 visits and then $79 per visit after the 30 visits allowed by insurance was $2,480. Seeing us out-of-network, the client is reimbursed 80% for sessions costing $79 each time. The total cost after the 80% reimbursement is $790, which is far less than the $2,480 per year for in-network services. The situation has been similar for about 75% of our clients. Even better, the insurance company isn't dictating what the child can work on and has no access to the child's records.
Note that because we are in network with Blue Cross, their subscribers are unfortunately not able to save money using out of network benefits. However, clients with all other types of private insurance may be eligible for these savings.
Here is how it works to use out-of-network insurance benefits:
1. You pay the therapy cost (typically $79). This is done by automatically charging your card each time you have an appointment.
2. We provide superbills and invoices on the 10th of each month for the previous month.
3. You provide the superbills to your insurance company, as instructed by them.
4. They pay you the amount corresponding to your insurance plan. Only your insurance company can determine this, and you have the right to ask them.
Our clients find that what we do is so effective that it’s well worth the extra step of submitting for reimbursement. Most are paying less than they would for an in-network provider.
Example of a client switching from an in-network provider to an out-of-network provider and saving money:
The client has a $30 copay for speech therapy and 30 visits allowed per year. This is a common speech therapy benefit through a good insurance plan. Total cost of 50 sessions (i.e., 1x weekly for a year) for services costing $30 for the first 30 visits and then $79 per visit after the 30 visits allowed by insurance was $2,480. Seeing us out-of-network, the client is reimbursed 80% for sessions costing $79 each time. The total cost after the 80% reimbursement is $790, which is far less than the $2,480 per year for in-network services. The situation has been similar for about 75% of our clients. Even better, the insurance company isn't dictating what the child can work on and has no access to the child's records.
Note that because we are in network with Blue Cross, their subscribers are unfortunately not able to save money using out of network benefits. However, clients with all other types of private insurance may be eligible for these savings.