Medicare Will Implement New Speech Therapy Billing Rules

Federal regulators will update billing guidelines for speech-language pathologists starting on Jan. 1.

Updated on Sept. 21, 2026 in Healthcare

Isometric editorial illustration of a metal tuning fork resting next to a textured foam acoustic tile on a plain surface. — The Centers for Medicare and Medicaid Services will implement new billing codes for speech-language pathologists on January 1 to streamline reimbursement processes. AI Illustration. Upload story photo >

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Will new Medicare billing guidelines make it harder for patients to access speech therapy sessions?

The Centers for Medicare and Medicaid Services will implement new billing codes for speech-language pathologists on Jan. 1. The changes follow an analysis by the American Medical Association and the agency regarding high usage rates of existing codes.

Why it matters

The American Speech-Language-Hearing Association sought the update, arguing current codes were outdated. However, therapists worry that the transition to more restrictive coding will lead to smaller payouts and longer patient wait lists.

The transition replaces the current system with 10 new billing codes. Proposed reimbursements for speech-only articulation sessions will drop to $56 from the current $76 rate.

The players

Centers for Medicare and Medicaid Services

This federal agency within the U.S. Department of Health and Human Services administers the Medicare program and works with the American Medical Association to set coding standards.

American Medical Association

This professional association of physicians and medical students collaborates with government entities to define and regulate medical billing and procedural coding.

American Speech-Language-Hearing Association

This professional, scientific, and credentialing association represents speech-language pathologists and audiologists while advocating for standardized clinical practices.

The details

Under the new guidelines, speech therapists will be restricted to billing one code per session instead of multiple codes for diverse treatment areas. Practitioners will also be required to maintain longer appointment durations under these new reimbursement structures.

The American Medical Association and CMS identified high billing code usage throughout 2024.
New Medicare billing changes are scheduled to take effect Jan. 1.

Market Landscape

This move aligns with broader efforts by federal agencies to regulate healthcare billing and curb rising costs across specialized therapy fields. It reflects a shift toward more granular reporting requirements that impacts how private practice providers manage their revenue streams.

Patients may face longer wait times for therapy appointments as clinics adjust to the lower reimbursement environment. Service availability could become restricted if private practices struggle to maintain operations under the new financial model.

The takeaway

Therapists should review the 10 new codes immediately to prepare their billing departments for the Jan. 1 transition. Adapting clinical documentation practices now may help mitigate the financial impact of the lower reimbursement rates.