Published in the August 2026 issue of the ISHA Voice
By Carrie Kerr, ASHA STAR for Illinois
Recent discussions at the national level continue to highlight significant concerns regarding speech-language pathology reimbursement and access to care. We want to ensure you are aware of these upcoming changes and how you can help advocate for our profession in Illinois.
Upcoming CPT Code Changes
CMS has proposed new SLP treatment CPT codes to replace CPT 92507 beginning January 1, 2027. While ASHA supports this new framework, CMS has also proposed a Medicare-specific pediatric G code (GSLPP) that was not requested by ASHA. This could increase administrative burden and cause provider confusion. Please note that while these codes take effect for Medicare in January 2027, private payers, Medicaid, and early intervention programs may be slow to adopt them.
Reimbursement Reductions and Network Adequacy
We are seeing private insurance reimbursement reductions affecting SLP services across the country. Additionally, insurance networks may appear compliant on paper, but many families still struggle to access care because participating providers cannot accept new patients at current reimbursement rates. Following our recent "secret shopper" survey investigating Medicaid Network Adequacy in Illinois, we continue to focus on real-world access to services and the enforcement of EPSDT requirements for Medicaid-enrolled children.
How You Can Help
Effective advocacy begins with individual clinicians. We need your help to track these trends and address them through coordinated advocacy efforts. Please document and share your experiences regarding:
- Private insurance reimbursement cuts
- Insurance network adequacy barriers
- Challenges with billing and access to care
You can also visit the ASHA Take Action Center (https://www.asha.org/advocacy/takeaction/) to participate in current national efforts.
Please reach out to share your experiences or to collaborate on advocacy initiatives. Together, we can ensure our voices are heard.