Frequently Asked Questions

Understanding Your Costs with Insurance for Speech Therapy

Your out-of-pocket costs (cost share) are determined by several factors specific to your insurance coverage:

• Plan details: your specific provider and plan tier.
  • Deductibles
  • Co-Pays
  • Co-Insurances
  • Authorizations
• Benefit type: whether your plan covers speech therapy as a habilitative or rehabilitative benefit (some plans may exclude these entirely).
• Service coding: the specific medical codes used for your treatment will vary.

We cannot determine this information without contracting your insurance provider for benefits, eligibility, and contracted fee schedules.

If insurance information is provided and services are covered, we are required to submit claims to the applicable insurance plan in accordance with our payer agreements.

Self-Pay Costs

• Speech Pathology Services
  • $248 for initial consult
  • $124 for follow-ups
• Lactation Services
  • $185 for initial consult
  • $98 for follow-ups
• Wellness Services
  • $98 Face & Fascia
  • $89 CST / Reiki (Mini)
  • $185 CST / Reiki (Standard)

We are in-network with multiple health plans. Please refer to the "Do you accept insurance?" section for a current list of participating insurers.

Insurance Billing

For patients utilizing insurance, we will submit claims in accordance with our contractual obligations. Coverage, co-payments, deductibles, and authorization requirements vary by plan, and patients remain responsible for understanding their individual benefits.

A cost estimate will be provided upon request.

Self-Pay

Patients may elect to receive services on a self-pay basis or if insurance deems services "not medically necessary."

See Self-Pay Costs above for current rates.

CareCredit Financing

We also partner with CareCredit for flexible financing on out-of-pocket costs.Learn about CareCredit.

If insurance information is provided and services are covered, we are required to submit claims to the applicable insurance plan in accordance with our payer agreements.

Yes, we do.

Speech-Language Pathology & Myofunctional Therapy

• Tricare East (Prime and Select)
• Aetna VA
• Aetna Better Health
• Anthem BCBS (Federal, Healthkeepers, Healthkeepers Plus)
• Sentara Health Plans
• Sentara Family Plans
• Medicare
• Cigna
• ChampVA
• Humana (ChoiceCare, Health Horizons)

Lactation Consulting

• Cigna (Via Wildflower Health)
• Anthem Plans (Virtual-only, via Wildflower Health)
• Aetna VA (Via The Lactation Network)
• UnitedHealthcare (Via The Lactation Network)
• Veterans CCN Optum (Via The Lactation Network)
• Multiplan (Via The Lactation Network)
• PNOA (Provider Network of America, via The Lactation Network)
• Imagine (Via The Lactation Network)
• Velocity (Via The Lactation Network)
• Tricare East

See Insurance & Accepted Plans for billing details and self-pay options.

Short answer, no.

Insurance will pay for medically necessary services, which means a doctor's script with a code and signature for your plan.

However, services that improve your quality of life do not always equal medical necessity to your insurance plan.

Scheduling Policy

• Appointments are scheduled on a first-come, first-served basis.
• Scheduling opens on the first business day of the third month of each season:
  • Spring: March–May
  • Summer: June–August
  • Fall: September–November
  • Winter: December–February

Cancellation & No-Show Policy

• Same-day cancellations are considered missed appointments.
• Patients are responsible for notifying the clinic of anticipated scheduling conflicts at least 24 hours in advance.
• Friday appointments cannot be rescheduled and will be counted as a missed appointment unless canceled at least 24 hours in advance.
• Canceling an appointment after a missed appointment is considered a no-show/missed appointment.

Cancellation & No-Show Fees

Ongoing Therapy Appointments (after initial evaluation)

• Same-day cancellation: $50
• No-show: $124
• Fee is applied for any cancellation less than 24 hours prior to the appointment.
• Friday appointments follow the same fee structure and cannot be rescheduled.

Initial Evaluation Appointments

• Same-day cancellation or no-show: $248
• This fee must be paid in full before rescheduling an initial evaluation.

We recognize the challenges, particularly for families with small children, that may affect attendance. We strive to be accommodating and flexible. Options for rescheduling or switching to a video session are available, if appropriate.

Payment Policy for Missed Appointments

• A credit or debit card must be kept on file for all patients.
• Fees for same-day cancellations and no-shows will be charged automatically according to the policies above.
• Children receiving both physical therapy and speech therapy are scheduled for separate appointments, even if services occur concurrently.

Attendance Policy

Regular attendance is critical. In order to achieve optimal therapeutic gains, patients are urged to adhere to the prescribed frequency of therapy sessions. Punctuality is appreciated. Late arrival to an appointment will result in a reduced session time and the full session fee will still apply.

Patients must maintain at least 80% attendance over a3-month period. Poor attendance may result in changes to scheduling privileges, including being limited to one appointment at a time, placement on a waitlist, or discharge from the clinic.

Insurance Policy

Insurance billing requires active coverage at the time of service, acknowledgment of clinic attendance policies, and submission of all required documentation, including valid prescriptions, authorizations, and intakes. Appointments completed during a lapse in coverage are not billable to insurance and will ultimately be the patient's responsibility.