Evaluation versus treatment coding
Speech evaluations and treatment are billed separately, and evaluation types differ by complexity. Billing treatment on an evaluation day, or the wrong evaluation code, produces denials.
Specialties › Speech, Pediatric & ABA-Adjacent Therapy
Speech Therapy & Pediatric Therapy Billing Services
Speech-language pathology and pediatric therapy sit in a coverage gray zone that costs practices dearly. Payers scrutinize whether therapy is rehabilitative or developmental, whether it duplicates school or early-intervention services, and whether continued treatment shows measurable progress. Combine that with authorization-heavy plans and a mix of timed and untimed codes, and pediatric therapy becomes a specialty where clean documentation is the difference between getting paid and not.
What makes it hard
Speech, Pediatric & ABA-Adjacent Therapy billing challenges we solve
These are the issues that repeat every month in speech, pediatric & aba-adjacent therapy practices — and the ones we fix at the source rather than reworking claim by claim.
Rehabilitative versus developmental coverage
Many plans cover rehabilitative therapy but exclude purely developmental or educational services. Documentation must frame medically necessary, restorative care to be covered.
Authorization and visit limits
Pediatric therapy plans frequently cap visits and require authorization, and continued authorization depends on documented progress toward goals.
Timed and untimed codes
Some therapy codes are untimed per session while others are timed. Mixing the two incorrectly, or misapplying timed-code rules, systematically misbills a high-volume practice.
Coordination with schools and early intervention
When a child also receives services through a school or early-intervention program, payers deny what they consider duplicate care unless the clinical role is clearly distinct.
Coding depth
Common code families we work with
- 92521 / 92522 / 92523 / 92524 — evaluation of speech, language and voice
- 92507 — treatment of speech, language and communication disorder
- 92508 — group speech treatment
- 92526 — treatment of swallowing and feeding disorders
- 97110 / 97112 / 97530 — therapy codes on multidisciplinary pediatric teams
- Authorization tracking and visit-limit management
- 99202–99215 — evaluation and management where applicable
Listed for context only — this is not billing advice, and payer policy varies. Our certified coders work to AAPC and AHIMA standards.
Denial prevention
Top denial drivers in speech, pediatric & aba-adjacent therapy
- Service considered developmental or educational, not rehabilitative
- Authorization exhausted or continued progress not documented
- Treatment billed on an evaluation-only day
- Timed-code rules misapplied
- Care denied as duplicative of school or early-intervention services
We root-cause denials by payer and procedure, then fix the upstream workflow so the same denial stops recurring.
Why ERG
What you get with ERG
Specialty-trained billers
Your account is worked by people who bill speech, pediatric & aba-adjacent therapy every day — not a general pool learning your rules on your claims.
95%+ net collection rate
Relentless follow-up on every claim, with aged A/R worked rather than written off.
No long-term contract
Performance-based pricing — a percentage of what we collect. Stay because the results are good, not because you are locked in.
5–10 day onboarding
We run parallel with your current process until the transition is verifiably clean.
Human-led, AI-supported
Our certified coders work every claim; AI tools help them catch more before submission.
HIPAA-compliant throughout
Strict PHI controls, access limits and staff training across the whole workflow.
FAQ
Speech, Pediatric & ABA-Adjacent Therapy billing — common questions
Do you bill pediatric speech and feeding therapy?
Yes. We bill speech, language, voice and swallowing evaluation and treatment for pediatric and adult patients, with attention to the evaluation-versus-treatment and timed-versus-untimed rules that trip up general billers.
How do you handle developmental versus rehabilitative denials?
By ensuring documentation frames medically necessary, restorative therapy toward measurable goals. That framing is what separates covered rehabilitative care from the developmental services many plans exclude.
Can you manage authorizations and visit limits?
Yes. Pediatric therapy is authorization- and limit-heavy, and continued authorization depends on documented progress. We track units and initiate re-authorization before limits are reached.
Do you work with multidisciplinary pediatric clinics?
Yes. We bill clinics that combine speech, occupational and physical therapy, coordinating the codes and authorizations across disciplines under one practice.
Client results
What practices say about working with us
★★★★★Our A/R days dropped from 58 to 31 in one quarter. First time in years I actually trust my numbers.
— Sarah M., Practice Manager
★★★★★Denials were killing us. First-pass acceptance went up fast, and they tell us why a claim failed — not just rework it quietly.
— Michael R., Billing Lead
Next step
See what your speech, pediatric & aba-adjacent therapy practice is leaving uncollected
A no-obligation A/R analysis. We review your aging, denial patterns and coding mix, then show you exactly where the recoverable revenue is.
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