Insurance Billing and Patient Responsibility:

• In-person regular 45 to 60-minute therapy visits within the Takes2Therapy service area with a full evaluation to determine the plan of care, formal report, and follow-up therapy visits based on the plan of care

• Coverage may be dependent on medical necessity, age, and/or specific medical diagnosis (ICD-10 code)

• Physician documentation and referral may be required to establish medical necessity

• Reimbursement/patient responsibility varies based on individual insurance coverage 

  • Takes2Therapy will directly bill in-network insurance who will determine coverage and patient responsibility

  • Takes2Therapy will inform you of any patient responsibility (applied to your deductible, copay, coinsurance)

  • If there is a covered secondary insurance, Takes2Therapy will file primary and secondary insurance claims

  • If claims are denied, the patient/family is responsible for the "self-pay" rate

 

In-Network Private/Medicaid Insurance:

• Blue Cross Blue Shield

• Blue Cross Blue Shield Medicaid Star/Chip & StarKids*

• Traditional Medicaid*

• United

  *other Medicaid programs, not a provider (i.e. Superior)​

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Parents are encouraged to call insurance to inquire regarding their individual plan's speech therapy coverage, including:

• General benefits and eligibility for speech therapy provided in the home (not home health care benefit)

• Any limitations or exceptions

• Copays/coinsurance/out of pocket

• Deductibles

• Pre-authorization or care notification requirements for speech therapy CPT codes (listed below) provided in the home

• Coverage of Telehealth Services (if needed)

 

Specific procedure/CPT codes for “Speech Therapy” will include:

• 92610 (Feeding/Swallowing Evaluation)

• 92523 (Speech/Language Evaluation)

• 92526 (Feeding/Swallowing Therapy)

• 92507 (Speech/Language Therapy)

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Self-Pay Speech Therapy Rates:

• Initial Evaluation:  $300 (45 minute visit with formal report/plan of care)

• Follow-up Treatment:  $125-150 (45 to 60-minute visit)

• Hourly Rates:

  • $125 45 minutes

  • $150 60 minutes

  • $225 90 minutes

  • $300 120 minutes

  • Hourly Rates apply when additional time is needed to implement/adjust plan of care

• An itemized invoice of services and payment will be provided

  • Families may submit paid invoice to insurance to apply to your out-of-network benefits

• Telehealth consultation provided via secure online video/audio connection

 

"No Show" Fee: $60 "no show" fee if the appointment is not canceled before the therapist's arrival

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Family Payment Options:

• Check paid to Takes2Therapy with an itemized paid invoice emailed upon request after payment

• Square itemized invoice with a paid invoice sent electronically after payment

• Venmo @Carmen-Huston-1 with an itemized paid invoice emailed upon request after payment