Adding myofunctional therapy to an SLP practice

This guide is for speech-language pathologists treating children, adults or both who are considering orofacial myofunctional therapy. ASHA places it within SLP practice for appropriately trained clinicians on a team.⁠¹ Evaluate function, refer what is medical or dental, never diagnose sleep apnea or a bite problem, and claim only what the evidence and your training support.

What is orofacial myofunctional therapy, and who provides it?

Orofacial myofunctional therapy (OMT) treats orofacial myofunctional disorders (OMDs), and ASHA describes it as provided by appropriately trained SLPs on a collaborative team. ASHA defines OMDs as oral and orofacial movement patterns that result in incorrect tongue positioning at rest and during swallowing, breathing and speech, at any age, and can co-occur with speech and swallowing disorders.⁠¹ The signs it lists include a habitual open-mouth, lips-apart resting posture, distorted /s/ and /z/ often with an interdental lisp, drooling and reduced oral control past age 4, an inconsistent lingual-palatal seal or tongue thrust during swallows, and sleep-disordered breathing.⁠¹

Prevalence estimates vary with the definition used: ASHA reports tongue thrust swallow in 5.4% to 62.3% of school-aged children across studies, and OMD estimates of 62% to 73.3% among people in orthodontic treatment.⁠¹

Other professions practice it too: the AAPD lists myofunctional therapists among the providers a dentist may refer to, and the AOMT notes that myofunctional therapy has no license of its own, so practicing it rests on the scope of an allied health license.⁠^5,10 For an SLP, that is the speech-language pathology license, and this guide works inside it. ASHA also notes that OMDs are usually treated in private practice, clinic or hospital settings and are not typically treated in public schools.⁠³

How do you decide whether to offer myofunctional therapy?

Decide on readiness rather than demand: add the service when a named clinician is trained for it, the referral partners are in place, every claim you plan to make has a source, and families can choose without being sold a package. The table sets out the decisions and the record each one should leave behind.

The specialty guide covers testing demand and resources for any new service, and the SLP startup guide covers licensure, the service inventory and Medicare enrollment.

Is orofacial myofunctional therapy within an SLP’s scope of practice?

Yes, for an SLP who is competent in it. ASHA’s Scope of Practice names orofacial myofunctional disorders, including open-mouth posture, orofacial habits, tethered oral tissues, chewing, and lip and tongue resting position, among the potential etiologies of communication and swallowing disorders, while noting that an SLP practices only where competent by education, training and experience.⁠¹¹ ASHA’s portal adds that these SLPs should follow local laws, regulations and employer standards as well as the scope document.⁠¹

What can an SLP not diagnose or decide in myofunctional care?

Medical and dental diagnoses, and the decision to operate. ASHA states that competent SLPs diagnose communication and swallowing disorders but do not differentially diagnose medical conditions.⁠¹¹ The table shows who answers the questions an OMD referral tends to raise.

Dental specialists draw the same line: the AAO says orthodontists cannot diagnose and treat obstructive sleep apnea independently.⁠¹⁴ Nor is a questionnaire a diagnosis: the American Academy of Sleep Medicine recommends against diagnosing adult OSA with questionnaires or prediction tools in the absence of polysomnography or home sleep apnea testing.⁠¹⁵

What training do SLPs need before offering myofunctional therapy?

Enough documented education and mentored experience to meet ASHA’s standard of being specifically educated and appropriately trained, since no single credential is required.⁠^1,5 ASHA’s code bars misrepresenting credentials, competence, education, training or experience.⁠⁸ Two organizations run well-known routes; the table gives their requirements as each describes them, and neither is endorsed here.

Neither credential widens scope or changes how a claim is paid: the IAOM states that it has no authority to interpret or dictate any professional’s licensure or scope of practice, and the AOMT that its certification has no bearing on U.S. insurance billing.⁠^4,5 ASHA lists the IAOM among resources whose inclusion does not imply endorsement.⁠¹ The training and equipment guide covers weighing a course’s full cost and break-even against the caseload it serves.

Should an SLP list a myofunctional credential on a website or listing?

Only exactly as the issuing body grants it, only while it is current, and only for the clinician who holds it. ASHA’s code bars misrepresenting credentials and requires telling clients the name, role and credentials of whoever provides services, and the IAOM ends COM status when dues lapse.⁠^4,8 A course certificate is not a certification: write "completed [course title], [the year]."

Which children and adults are candidates for myofunctional therapy?

Children old enough to take an active part, and adults, once airway and structural questions are with the right professionals. ASHA notes that OMT may not suit children under 4 or anyone who cannot self-monitor or follow directions, the IAOM calls it not applicable to infants, and the AAPD says any habit treatment must suit the child’s development and ability to cooperate.⁠^3,10,18

Age changes what is typical. ASHA notes that a lips-apart posture is normal before the lips are fully grown, with most people reaching a lips-together rest posture around 12 to 13 years of age, and the AAPD calls nonnutritive sucking normal in infants and young children.⁠^2,10

Adults may come on their own or by referral. ASHA notes that SLPs might receive referrals to treat sleep-disordered breathing with OMT, and that SLPs address chewing pain from temporomandibular disorders together with dentists.⁠³ An adult decides about their own care, so the intake speaks to the client, not the referring office.

Where does feeding therapy end and myofunctional therapy begin?

At infants and at swallowing safety: a baby with feeding difficulty needs a feeding evaluation and a team, not a myofunctional program. ASHA calls a team approach necessary for pediatric feeding and swallowing disorders, says feeding-specialist SLPs typically lead it, and lists occupational therapists among the professionals the SLP refers to; AOTA describes OT’s crucial role in feeding, eating and swallowing across the lifespan.⁠^19,20 For a breastfeeding infant, an IBCLC’s scope includes maternal, child and feeding assessments and a feeding plan.⁠²¹

People with OMDs can also have oral phase dysphagia, which ASHA notes may need its own intervention, so a swallowing concern goes to the clinic’s feeding or dysphagia service.⁠³ The NICU follow-up guide covers the infant feeding route.

How should an SLP screen myofunctional inquiries at intake?

Screen to route, not to diagnose: the intake call decides whether the person books an SLP evaluation, needs another professional first, or both. The checklist turns ASHA’s OMD case history items into intake questions.⁠² Its sleep questions follow the findings the AAPD associates with OSA in children, such as snoring, observed apnea and bedwetting, and those the AAO lists for adults, such as gasping, choking and morning headaches.⁠^10,14

Add these questions to the service-fit step of the intake call script rather than running a separate call.

Who belongs in a myofunctional therapy referral network?

The professionals who answer the questions an SLP cannot: dentistry, orthodontics, otolaryngology, sleep medicine, allergy, lactation and, for feeding, occupational therapy. ASHA’s list of those an SLP refers to and collaborates with also includes oral and plastic surgeons, physicians, respiratory therapists and orofacial myologists.⁠² Each core partner’s role, in its own body’s words:

• Dentists. The AAPD has the dentist evaluate habit frequency, duration and intensity in every patient with a habit.⁠¹⁰
• Orthodontists. The AAO describes orthodontists as specialists in bite and tooth alignment who complete an accredited program after dental school, and recommends a first orthodontic check-up no later than age 7.⁠²²
• Otolaryngologists. ENT Health, the AAO-HNS Foundation’s patient site, tells parents to have a child with sleep-disordered breathing symptoms checked by an ENT, and calls tonsil and adenoid removal generally the first-line treatment when symptoms are significant and the tissue is enlarged.⁠¹³
• Sleep medicine. The AASM makes polysomnography the standard test for adult OSA, with home testing an option for some adults; the AAP recommends polysomnography for children who snore and show signs of OSA.⁠^12,15
• Lactation consultants. An IBCLC’s scope covers breastfeeding assessments, feeding plans and referral; the IBLCE says frenulotomy is not an authorized procedure for an IBCLC unless separately licensed for it.⁠^21,23

Fill in one row per partner before the first referral arrives; the pediatrician referral guide and the adult referral guide cover introducing a practice to referral sources.

How should an SLP work with a frenotomy or release provider?

As the person who describes function, never as a gatekeeper or the seller of a pre-release program. The release decision is medical, made case by case by dentists, oral surgeons and otolaryngologists; ASHA notes that not every tongue-tie needs a frenotomy and that non-surgical interventions may come first.⁠² On a release team, ASHA has the SLP inform the family’s decision and treat feeding and speech function, and leaves wound management to the surgeon.⁠³

The evidence behind releases is limited and contested. The AAP’s 2024 clinical report states that whether releasing a tight lingual frenulum in newborns improves breastfeeding is not clear and that a team partnership is necessary.⁠²⁴ ASHA describes the research on tongue-tie and later speech as conflicting but trending toward minimal to no impact, and the Australian Dental Association finds no evidence supporting orofacial myofunctional therapy for managing ankyloglossia.⁠^1,25 DrSensory’s family guides to tongue ties and lip ties set out that evidence; send families there rather than writing a release protocol into your marketing.

Can you share records with dentists and orthodontists?

Yes, for treatment, with the family or adult client told who receives what. HHS’s HIPAA guidance lets a covered entity disclose protected health information for the treatment activities of any health care provider, and defines treatment to include coordination, consultation between providers and referral.⁠²⁶ Say at intake which partners receive your reports, and send each the findings its question needs.

Can a dental office pay you for myofunctional referrals?

Not for federal health care program patients, and avoiding referral payments altogether is the safer rule. OIG describes the Anti-Kickback Statute as a criminal law against paying remuneration, meaning anything of value, to induce or reward referrals of items or services payable by federal health care programs, and it reaches the recipient as well as the payer.⁠²⁷ ASHA’s code requires disclosure and management of any conflict of interest that cannot be avoided.⁠⁸ Seeing clients inside a dental office, sharing revenue or selling a joint package needs your adviser’s review first.

What does the evidence show for myofunctional therapy outcomes?

It depends on the outcome, so each claim needs its own source and its own strength. A 2020 Cochrane review of nine randomized trials with 347 participants, 13 of them children, lasting two to four months, found that compared with sham therapy, myofunctional therapy probably reduces daytime sleepiness and may improve sleep quality in the short term, with certainty from moderate to very low.⁠⁶ On low-certainty evidence, it may reduce the apnea-hypopnea index compared with sham but leave it higher than CPAP does, and in children it may make little to no difference to that index when added to nasal washing.⁠⁶

An earlier meta-analysis in SLEEP, of nine adult studies with 120 patients and two pediatric studies with 25, concluded that myofunctional therapy could serve as an adjunct to other OSA treatments, and ASHA says more studies are needed on adherence and long-term effects.⁠^3,28

ASHA keeps an OMD Evidence Map of research summaries; recheck it and the sources in the register below whenever a claim is reused.⁠¹

How do you document myofunctional evaluations and outcomes?

Record what you observed, what you measured, whom you referred to and what changed, in terms another professional and a claims reviewer can follow. ASHA has SLPs document observations of anatomical or physiological differences while leaving medical diagnosis to others, and its assessment covers resting posture, lip closure, tongue and lip movement in swallowing, speech sound placement and the dentition, which is noted but not diagnosed.⁠² Measures with published reliability help:

• OMES. The Orofacial Myofunctional Evaluation with Scores grades lips, tongue, cheeks and jaws, breathing, chewing and swallowing in children aged 6 to 12, and its authors report it valid and reliable within the limits of its items.⁠²⁹
• NOT-S. The Nordic Orofacial Test-Screening pairs a structured interview with an examination, was studied in patients aged 3 to 86, and reported a sensitivity of 0.96 and a specificity of 0.63; its authors present it as a screening.⁠³⁰
• Your own repeatable measures. Target-sound accuracy in words and conversation, and photographs of rest posture taken the same way each time with consent recorded.

Sleep outcomes are the physician’s to measure: the apnea-hypopnea index comes from polysomnography or home testing, so report it from the physician’s results.⁠¹⁵ ASHA’s code requires SLPs to evaluate the effectiveness of their services, provide services only when benefit can reasonably be expected, and keep timely, accurate records.⁠⁸ Payers may also set documentation requirements of their own.⁠³¹

How do insurance and CPT codes apply to myofunctional therapy?

Coverage is decided payer by payer, and ASHA’s coding pages describe no code specific to myofunctional therapy, so the codes follow the disorder actually evaluated or treated. ASHA states that no specific billing codes address sleep-disordered breathing treated by an SLP and tells SLPs to check each payer; its coding guidance is to select the code that most accurately describes the disorder treated, the service and the contact time.⁠^3,32 The codes below are those ASHA’s pages describe for services an OMD caseload often involves, a starting list for a payer conversation, not a coding instruction.

Read each plan’s policy before quoting a family. Aetna’s speech therapy policy, for example, covers communication and swallowing disorders "from disease" under a plan of care approved by the treating physician, and calls procedures a family can carry out at home on their own, or self-correcting developmental articulation errors, not medically necessary; its adult sleep apnea policy lists oropharyngeal exercises as experimental, investigational or unproven.⁠^34,35 Some payers require a prescription even though, as ASHA notes, SLP services are not prescribed by another professional, so a dental referral may not meet a plan that wants a physician’s order.⁠¹¹ For Medicare patients, outpatient SLP services need a plan of treatment certified by a physician, nurse practitioner, clinical nurse specialist or physician assistant, recertified at least every 90 days.⁠³⁶ The SLP startup guide covers Medicare enrollment and its private-pay rules.

When a plan does not cover the service, give the self-pay fee, what it includes and the cancellation terms in writing before the first visit; the payment guide covers how to explain them.

How do you explain myofunctional therapy options to clients?

Evaluation first, then a plan with its uncertainty, its cost and its alternatives, including waiting. ASHA’s code requires informed consent about the nature and possible risks and effects of services, including the possible effects of not engaging in treatment, and allows services only when benefit can reasonably be expected.⁠⁸ That rules out selling a program before an evaluation, prepaid packages with no exit, and bundling OMT with someone else’s release or appliance.

For a child, the parent consents and the child’s motivation matters: the AAPD notes that a child’s desire to stop a habit helps.⁠¹⁰ An adult consents for themselves, and an adult with sleep apnea should hear plainly that, compared with CPAP, OMT may leave the apnea-hypopnea index higher, so it is discussed as an addition to the physician’s treatment, not a replacement.⁠⁶

What does a myofunctional referral look like in practice?

A referral usually carries a question another professional owns as well as one the SLP owns; the work is to answer yours and route the rest, as the two hypothetical situations below show.

How can you market myofunctional services without overclaiming?

Describe the service, the clinician and the process, and leave out outcomes the evidence does not support and diagnoses you do not make. ASHA’s code requires public statements to give accurate information, bars misrepresentation when advertising services, and bars any promise, direct or implied, of treatment results.⁠⁸

Federal advertising law reaches service ads too. The FTC’s Endorsement Guides define "product" to include any service and read a client’s account of a key result as a claim that it is typical, and FTC guidance says health claims usually need competent and reliable scientific evidence, which satisfied-customer statements usually are not.⁠^9,37 Its staff’s health guidance even calls a snoring product’s ad deceptive if it fails to disclose that the product does not treat sleep apnea.⁠³⁸

Client photos and stories need written permission: HIPAA requires an authorization for any use or disclosure of protected health information for marketing, apart from face-to-face communication and gifts of nominal value.⁠³⁹ The FTC’s review rule bars incentives for reviews expressing a particular sentiment, and the reviews guide covers asking for reviews.⁠⁴⁰

On DrSensory, every clinic has a basic listing at no cost and claiming it is free; a paid listing adds a description in the clinic’s own words, specialties, and ages and conditions treated, among other fields. List myofunctional therapy only when a clinician at that address provides it, describe it without outcome claims, and keep it current. DrSensory does not verify clinical quality. The claim and optimize guide, the directory profile guide and the pricing page cover the rest.

Sources

1. American Speech-Language-Hearing Association. Orofacial Myofunctional Disorders (Practice Portal clinical topic, Overview, Incidence and Prevalence, Signs and Symptoms, and Roles and Responsibilities sections; acknowledgments list 2025 revisions). Checked October 23, 2026.
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   “OMDs are movement patterns that involve oral and orofacial musculature, which result in incorrect positioning of the tongue at rest and during swallowing, breathing, and speech production. OMDs can occur across the lifespan”; “OMDs can co-occur with a variety of speech and swallowing disorders.”; “See the Orofacial Myofunctional Disorders Evidence Map for summaries of the available research on this topic.”; “Estimates of tongue thrust swallow in school-aged children range from 5.4% (Kasparaviciene et al., 2014) to 62.3% (Sasigornwong et al., 2016).”; “Higher OMD estimates are reported for individuals receiving orthodontic treatment (62%–73.3%; Hale et al., 1988; Stahl et al., 2007).”; “Research on the impact of ankyloglossia, or tongue-tie, on newborn feeding and later speech development is conflicting but trends toward outcomes showing minimal to no impact on speech and feeding”; “Habitual open-mouth, lips-apart resting posture.”; “Distorted productions of /s, z/, often with an interdental lisp”; “Drooling and lack of oral control, specifically past the age of 4 years”; “Lack of a consistent lingual–palatal seal and/or tongue thrust during swallows.”; “Sleep-disordered breathing or sleep apnea”; “Orofacial myofunctional interventions are conducted by appropriately trained speech-language pathologists (SLPs) as part of a collaborative team.”; “SLPs who serve this population should be specifically educated and appropriately trained to do so. Additionally, clinicians should adhere to ASHA’s Scope of Practice in Speech-Language Pathology (ASHA, 2016) as well as local laws and regulations and employer standards to guide their practice.”; “This list of resources is not exhaustive, and the inclusion of any specific resource does not imply endorsement from ASHA.”.
2. American Speech-Language-Hearing Association. Orofacial Myofunctional Disorders (Practice Portal clinical topic, Assessment section: Interprofessional Team, Case History, Assessment of the Orofacial Complex, Feeding and Swallowing, and Articulation). Checked October 23, 2026.
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   “Interprofessional practice is essential because assessment of OMDs has many possible aspects, which often require an integrated team approach.”; “The speech-language pathologist (SLP) makes a referral to and collaborates with one or more of the following professionals:”; “allergist”; “orofacial myologist”; “dentist”; “lactation consultant”; “occupational therapist”; “oral surgeon”; “orthodontist”; “otolaryngologist/ENT”; “physician”; “plastic surgeon”; “respiratory therapist”; “sleep apnea specialist”; “SLPs do not differentially diagnose medical conditions (ASHA, 2016). SLPs document observations of anatomical and/or physiological abnormalities during screening or assessment using various assessment tools, techniques, and data sources.”; “The decision to perform a frenectomy, frenotomy, or frenuloplasty is a medical decision made on a case-by-case basis by dentists, oral surgeons, and otolaryngologists. Not all patients with a tongue-tie need a frenotomy (Messner et al., 2020). Non-surgical interventions, such as alternative feeding techniques, may be considered before proceeding or considering surgical treatment options”; “Diagnosing malocclusions or TMJD is not within the SLP’s scope of practice. If concerns arise about the symptoms of malocclusions or TMJD, then referrals to a dentist, an orthodontist, and/or an oral and maxillofacial surgeon are considered.”; “SLPs refer clients to physicians for further medical examination and diagnosis if any concerns about sleep-disordered breathing arise during an SLP’s evaluation.”; “oral habits (e.g., thumb, digit, pacifier, object sucking)”; “prior interventions (e.g., surgery, lactation, physical therapy, occupational therapy, speech-language pathology services)”; “respiratory habits (e.g., nasal breathing vs. mouth breathing)”; “snoring and sleep habits”; “dental/orthodontic history”; “Lips-apart mouth posture is normal and age appropriate before the lips are fully grown”; “Most people can achieve lips-together resting posture around approximately 12–13 years of age”; “Status of the dentition, including occlusions and evidence of teeth grinding or clenching. (Although awareness of a malocclusion may be useful to the clinician, please note that diagnosing malocclusions is not within the SLP’s scope of practice.)”; “Difficulty achieving lip closure, or closure with accompanying muscle strain, could be related to the presence of lip incompetence.”; “The clinician observes the client’s tongue and lip movements in the handling and swallowing of saliva, liquids, and foods.”; “Speech assessment for clients with OMDs focuses on the placement of the articulators and the resting postures of the tongue, lips, and mandible.”; “A chronic, hyponasal voice quality suggests the presence of an upper airway interference and the need for ENT and allergy workups.”; “an orthodontist may need to treat a child’s open bite before the clinician provides interventions for a tongue thrust and/or an interdental lisp.”; “Breastfeeding difficulty for infants with a tongue-tie and their caregivers is a complex issue that requires multidisciplinary evaluation and management (Thomas et al., 2024).”.
3. American Speech-Language-Hearing Association. Orofacial Myofunctional Disorders (Practice Portal clinical topic, Treatment section). Checked October 23, 2026.
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   “Orofacial myofunctional disorders (OMDs) are usually treated in private practice, clinic, or hospital settings.”; “OMDs are not typically treated in public school settings.”; “OMTs may not be appropriate for children under the age of 4 years or who do not have the skills to self-monitor or follow directions”; “After an allergist, orthodontist, and otolaryngologist (ENT) rules out or corrects structural or physiological impediments to nasal breathing, OMT addresses the following”; “Closed-mouth posture cannot be consistently established until any airway interferences have been successfully resolved”; “Obstructive sleep apnea and sleep-disordered breathing are medical diagnoses, and treatment options are offered by a medical professional who is qualified to make that diagnosis.”; “Speech-language pathologists (SLPs) might receive referrals to treat sleep-disordered breathing using OMT. More studies are needed to evaluate compliance and the long-term effects of OMT on obstructive sleep apnea outcomes”; “Currently, no specific billing codes address sleep-disordered breathing when services are provided by an SLP. Therefore, SLPs should check with individual payers on reimbursement and payer coverage of sleep-disordered breathing.”; “SLPs exercise caution before using OMT as a standalone approach to address speech sound errors and may need to consider combining OMT and articulation interventions to address speech sound errors”; “People with known OMDs may also demonstrate oral phase dysphagia, which may require intervention. Clients and patients might have feeding difficulties due to TMD, such as pain with chewing certain foods. SLPs work closely with dentists and other health professionals with TMD expertise”; “SLPs might be asked to provide insight based on their expertise so that the client and their family/caregivers can make an informed decision. The SLP provides individualized interventions to address the functional implications on pre-feeding, feeding, and speech sounds”; “Wound management is designated to the surgeon and is carried out by the patient, caregivers, and professionals who can provide wound care protocols under their licensure and scope of practice.”.
4. International Association of Orofacial Myology. Membership and Certification (IAOM membership page with the Certified Orofacial Myologist (COM) certification steps). Checked October 23, 2026.
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   “IAOM active membership is available to healthcare professionals who have a background as: Dentist (DDS/DMD), Physician (MD/DO/BOst.), Registered Dental Hygienist (RDH), Dental Therapist (DT), Speech Language Pathologist (SLP), Physical Therapist (PT), Occupational Therapist (OT).”; “$250.00 – membership starts the date you join for one-year”; “Complete a 28-hour orofacial myofunctional therapy course”; “This must be from one course resulting in a minimum of 28 hours and not several courses total in 28 hours.”; “It is required for you to have worked with a minimum of two patients, ages four years or older, who have completed the entire program.”; “Once received and approved, you will be invoiced the $250.00 certification enrollment fee.”; “You have three-months to complete the proficiency examination which consists of 140 multiple choice questions.”; “The written proficiency examination must be passed with an 80% or higher.”; “Onsite evaluation in front of two IAOM appointed Board Certified Orofacial Myologist”; “Onsite evaluations are $850.00”; “In order to maintain your COM®, you must stay current in your IAOM Active Membership dues (annually based on the IAOM membership cycle of March 1 – February 28 th ) and maintain 20 CEUs every two-years starting the year after you earned your COM®. If dues are not paid you will lose your COM® status.”; “The IAOM does not have the ability or authority to interpret or dictate any healthcare professional’s licensure or scope of practice.”.
5. Academy of Orofacial Myofunctional Therapy. Certification Info Page (AOMT certification requirements). Checked October 23, 2026.
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   “While certification is not required in order to practice myofunctional therapy, more organizations are looking toward standards of training in order to protect providers and the public at large. Myofunctional therapy and sciences does not have a professional license of its own designation; therefore the ability to practice this therapy is based on the scope of practice within an allied health license.”; “100 Question Examination”; “Case Study Submission (2 total)”; “Confirmation of Mentorship Hours (the Myo Coffee Klatsch)”; “Observation of three allied health providers (2 hours minimum each provider)”; “Every three years you will be asked to provide proof of thirty continuing education hours.”; “The application and re-instatement fee is $225.00 USD. This renews your certification status for three years.”; “While certification may deepen trust between referring providers and the public, it has no bearing on insurance billing in the U.S.”; “One province in Canada requires certification (Alberta). Outside of Canada there are no areas the require certification in order to practice myofunctional therapy.”.
6. Rueda JR, Mugueta-Aguinaga I, Vilaró J, Rueda-Etxebarria M. Myofunctional therapy (oropharyngeal exercises) for obstructive sleep apnoea (Cochrane Database of Systematic Reviews. 2020;11:CD013449. doi:10.1002/14651858.CD013449.pub2, PMID 33141943; passages from the abstract). Checked October 23, 2026.
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   “The nine included RCTs analysed a total of 347 participants, 69 of them women and 13 children.”; “The studies’ duration ranged from two to four months.”; “In adults, compared to sham therapy, myofunctional therapy: probably reduces daytime sleepiness (Epworth Sleepiness Scale (ESS), MD (mean difference) -4.52 points, 95% Confidence Interval (CI) -6.67 to -2.36; two studies, 82 participants; moderate-certainty evidence); may increase sleep quality (MD -3.90 points, 95% CI -6.31 to -1.49; one study, 31 participants; low-certainty evidence); may result in a large reduction in Apnoea-Hypopnoea Index (AHI, MD -13.20 points, 95% CI -18.48 to -7.93; two studies, 82 participants; low-certainty evidence)”; “Compared to CPAP, myofunctional therapy may result in little to no difference in daytime sleepiness (MD 0.30 points, 95% CI -1.65 to 2.25; one study, 54 participants; low-certainty evidence); and may increase AHI (MD 9.60 points, 95% CI 2.46 to 16.74; one study, 54 participants; low-certainty evidence).”; “In children, compared to nasal washing alone, myofunctional therapy and nasal washing may result in little to no difference in AHI (MD 3.00, 95% CI -0.26 to 6.26; one study, 13 participants; low-certainty evidence).”; “Compared to sham therapy, myofunctional therapy probably reduces daytime sleepiness and may increase sleep quality in the short term. The certainty of the evidence for all comparisons ranges from moderate to very low, mainly due to lack of blinding of the assessors of subjective outcomes, incomplete outcome data and imprecision. More studies are needed.”.
7. American Speech-Language-Hearing Association. New Speech-Language Pathology CPT Codes (ASHA coding guidance, Speech-Language Pathology Treatment Codes Replacing 92507). Checked October 23, 2026.
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   “Key Dates: CPT code 92507 remains in effect through December 31, 2026. The new codes take effect January 1, 2027. Clinicians should not report the new codes before their effective date and should verify implementation requirements with each payer, as they may vary.”; “Beginning January 1, 2027, Current Procedural Terminology (CPT®) code 92507 will be replaced by a new family of 10 speech-language pathology treatment codes.”; “Other payers may decide if and when to implement the new codes into their fee schedules.”.
8. American Speech-Language-Hearing Association. Code of Ethics (2023 Code of Ethics, Principles I to IV). Checked October 23, 2026.
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   “Individuals shall provide all clinical services and scientific activities competently.”; “they shall inform those they serve professionally of the name, role, and professional credentials of persons providing services.”; “Individuals shall obtain informed consent from the persons they serve about the nature and possible risks and effects of services provided, technology employed, and products dispensed. This obligation also includes informing persons served about possible effects of not engaging in treatment or not following clinical recommendations.”; “Individuals who hold the Certificate of Clinical Competence shall evaluate the effectiveness of services provided, technology employed, and products dispensed, and they shall provide services or dispense products only when benefit can reasonably be expected.”; “Individuals may make a reasonable statement of prognosis, but they shall not guarantee—directly or by implication—the results of any treatment or procedure.”; “Individuals shall maintain timely records; shall accurately record and bill for services provided and products dispensed”; “Individuals shall not misrepresent their credentials, competence, education, training, experience, or scholarly contributions.”; “If such conflicts of interest cannot be avoided, proper disclosure and management is required.”; “Individuals’ statements to the public shall provide accurate information regarding the professions, professional services and products, and research and scholarly activities.”; “Individuals’ statements to the public shall adhere to prevailing professional standards and shall not contain misrepresentations when advertising, announcing, or promoting their professional services, products, or research.”.
9. Federal Trade Commission. 16 CFR Part 255, Guides Concerning the Use of Endorsements and Testimonials in Advertising (eCFR, sections 255.0 and 255.2). Checked October 23, 2026.
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   “For purposes of this part, the term ‘product’ includes any product, service, brand, company, or industry.”; “Consumer endorsements themselves are not competent and reliable scientific evidence.”; “An advertisement containing an endorsement relating the experience of one or more consumers on a central or key attribute of the product will likely be interpreted as representing that the endorser’s experience is representative of what consumers will generally achieve with the advertised product in actual, albeit variable, conditions of use.”.
10. American Academy of Pediatric Dentistry. Management of the Developing Dentition and Occlusion in Pediatric Dentistry (best practice, latest revision 2024, The Reference Manual of Pediatric Dentistry 2025, pages 497 to 515, Oral habits). Checked October 23, 2026.
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    “The relationship between oral habits and unfavorable dental and facial development is associational rather than cause and effect.”; “Oral habits include, but are not limited to, nonnutritive sucking, bruxism, tongue thrust swallow and abnormal tongue position”; “Nonnutritive sucking behaviors are considered normal in infants and young children.”; “it has been suggested that early dental visits provide parents with anticipatory guidance to help their children stop nonnutritive sucking habits by age 36 months or younger.”; “If the resting tongue posture is forward of the normal position, incisor displacement is likely, but if resting tongue posture is normal, a tongue thrust swallow has no clinical significance.”; “Historical findings associated with OSA may include snoring, observed apnea, restless sleep, daytime neurobehavioral abnormalities or sleepiness, and bedwetting.”; “The dentist should evaluate habit frequency, duration, and intensity in all patients with habits.”; “Any treatment must be appropriate for the child’s development, comprehension, and ability to cooperate. Habit treatment modalities include patient/parent counseling, behavior modification techniques, myofunctional therapy, appliance therapy (extraoral and intraoral), or referral to other providers including, but not limited to, orthodontists, psychologists, myofunctional therapists, or otolaryngologists.”; “The child’s desire to stop the habit is beneficial for managing oral habits.”.
11. American Speech-Language-Hearing Association. Scope of Practice in Speech-Language Pathology (official policy approved by the ASHA Board of Directors on February 4, 2016). Checked October 23, 2026.
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    “An SLP typically does not practice in all areas of clinical service delivery across the life cycle. As the ASHA Code of Ethics specifies, professionals may practice only in areas in which they are competent, based on their education, training, and experience.”; “Speech-language pathology services are not prescribed or supervised by another professional. Additional requirements may dictate that speech-language pathology services are prescribed and required to meet specific eligibility criteria in certain work settings, or as required by certain payers.”; “Competent SLPs can diagnose communication and swallowing disorders but do not differentially diagnose medical conditions.”; “Potential etiologies of communication and swallowing disorders include”; “Orofacial myofunctional disorders (e.g., habitual open-mouth posture/nasal breathing, orofacial habits, tethered oral tissues, chewing and chewing muscles, lips and tongue resting position).”.
12. Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J, et al.; American Academy of Pediatrics. Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome (clinical practice guideline, Pediatrics. 2012;130(3):576–584. doi:10.1542/peds.2012-1671, PMID 22926173; passages from the guideline’s abstract). Checked October 23, 2026.
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    “(1) All children/adolescents should be screened for snoring. (2) Polysomnography should be performed in children/adolescents with snoring and symptoms/signs of OSAS; if polysomnography is not available, then alternative diagnostic tests or referral to a specialist for more extensive evaluation may be considered. (3) Adenotonsillectomy is recommended as the first-line treatment of patients with adenotonsillar hypertrophy.”.
13. American Academy of Otolaryngology–Head and Neck Surgery Foundation, ENT Health. Pediatric Sleep-disordered Breathing (patient information page, last reviewed December 2018). Checked October 23, 2026.
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    “If you notice any of the symptoms described in this article, have your child checked by an ENT (ear, nose, and throat) specialist, or otolaryngologist.”; “Surgical removal of the tonsils and adenoids, called tonsillectomy and adenoidectomy (T&A), is generally considered the first line treatment for pediatric SDB if the symptoms are significant, and the tonsils and adenoids are enlarged.”; “Not every child with snoring needs to undergo T&A.”.
14. American Association of Orthodontists. Breathing Easy: How Orthodontics Can Alleviate Sleep Apnea (AAO article, October 28, 2024). Checked October 23, 2026.
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    “Although orthodontists cannot diagnose and treat obstructive sleep apnea independently, they may be the first medical professionals to recognize symptoms in adults and children.”; “Adults with obstructive sleep apnea often snore, gasp, or choke and may also experience pauses in breathing during sleep. Individuals with OSA often have frequent night awakenings, non-restorative sleep, morning headaches, excessive daytime sleepiness, difficulty with attention and concentration, and mood disturbances.”.
15. Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, Harrod CG; American Academy of Sleep Medicine. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (Journal of Clinical Sleep Medicine. 2017;13(3):479–504. doi:10.5664/jcsm.6506, PMID 28162150; passages from the guideline’s abstract). Checked October 23, 2026.
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    “Polysomnography is the standard diagnostic test for the diagnosis of OSA in adult patients in whom there is a concern for OSA based on a comprehensive sleep evaluation.”; “We recommend that clinical tools, questionnaires and prediction algorithms not be used to diagnose OSA in adults, in the absence of polysomnography or home sleep apnea testing. (STRONG).”; “We recommend that polysomnography, or home sleep apnea testing with a technically adequate device, be used for the diagnosis of OSA in uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA. (STRONG).”.
16. Academy of Orofacial Myofunctional Therapy. Intro to Orofacial Myofunctional Therapy (AOMT course enrollment page). Checked October 23, 2026.
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    “As myofunctional therapy and sciences does not have its own license designation, you will be required to hold a license in an allied health field to enroll in our Intro course. SLPs, RDHs, DDS, DMD, OTs, PTs, and others are mostly in our classes.”; “We are ASHA approved and offer 6.9 ASHA units (69 hours).”; “Upon completion of the Foundations course, you will be eligible for certification with the AOMT.”.
17. International Association of Orofacial Myology. Courses (IAOM course listing). “The courses listed for 28-hour Orofacial Myofunctional Therapy have agreed to include IAOM certification curriculum in their course. Each course provider is responsible for their course registration and course participants. The IAOM has no affiliation with course providers”. Checked October 23, 2026.
18. International Association of Orofacial Myology. FAQ (IAOM frequently asked questions). “orofacial myofunctional therapy is not applicable to infants or babies, due to the need for active involvement in the therapy process.”. Checked October 23, 2026.
19. American Speech-Language-Hearing Association. Pediatric Feeding and Swallowing (Practice Portal clinical topic). Checked October 23, 2026.
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    “A team approach is necessary for appropriately diagnosing and managing pediatric feeding and swallowing disorders.”; “SLPs who specialize in feeding and swallowing disorders typically lead the professional care team in the clinical or educational setting.”; “an occupational therapist (OT), or”; “SLPs may collaborate with occupational therapists, because motor control is an important consideration for using adaptive equipment.”. The third passage is an item in the portal’s list headed “Interventions by and referrals to”.
20. American Occupational Therapy Association. Feeding, Eating, and Swallowing (AOTA clinical topic page). “Occupational therapy practitioners play a crucial role in addressing feeding, eating, and swallowing challenges for clients across the lifespan.”. Checked October 23, 2026.
21. International Board of Lactation Consultant Examiners (IBCLC Commission). Scope of Practice for International Board Certified Lactation Consultant (IBCLC) Certificants (effective December 2018, PDF). Checked October 23, 2026.
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    “Performing comprehensive maternal, child and feeding assessments related to breastfeeding and human lactation.”; “Developing and implementing an individualised feeding plan in consultation with the client.”; “Making referrals to other health care providers and community support resources when necessary.”.
22. American Association of Orthodontists. Dentist and Orthodontist: Spot the Difference (AAO resource center page). Checked October 23, 2026.
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    “Orthodontists are specialists who focus on your bite and alignment of your teeth.”; “In addition to dental school, orthodontists must complete a program accredited by the Commission on Dental Accreditation.”; “The AAO recommends children get their first check-up with an AAO orthodontist no later than age 7.”.
23. International Board of Lactation Consultant Examiners. Advisory Opinion – Frenulotomy (issued February 2013, PDF). “frenulotomy is not an authorized procedure for IBLCE certificants unless they are separately licensed or authorized to perform frenulotomies in the applicable jurisdiction.”; “in the United States, frenulotomies must generally be performed by licensed healthcare professionals.”. Checked October 23, 2026.
24. Thomas J, Bunik M, Holmes A, Keels MA, Poindexter B, Meyer A, Gilliland A; American Academy of Pediatrics. Identification and Management of Ankyloglossia and Its Effect on Breastfeeding in Infants: Clinical Report (Pediatrics. 2024;154(2):e2024067605. doi:10.1542/peds.2024-067605, PMID 39069819; the passage is the report’s abstract). Checked October 23, 2026.
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    “Whether the release of a tight lingual frenulum in neonates improves breastfeeding is not clear. Because many of the symptoms of ankyloglossia overlap those of other breastfeeding difficulties, a team partnership is necessary.”.
25. Australian Dental Association. Policy Statement 2.13: Ankyloglossia and Oral Frena (adopted by Federal Council March 24, 2022; amended by the ADA Board October 24, 2025). Checked October 23, 2026.
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    “3.5 Breastfeeding issues can be associated with ankyloglossia. Current evidence shows nonsurgical management strategies as an effective first-line therapy for the management of functional limitations related to ankyloglossia.”; “3.12 There is no evidence supporting the use of musculoskeletal therapy or orofacial myofunctional therapy for the management of ankyloglossia.”.
26. U.S. Department of Health and Human Services, Office for Civil Rights. Uses and Disclosures for Treatment, Payment, and Health Care Operations (HIPAA Privacy Rule guidance; content last reviewed July 26, 2013). Checked October 23, 2026.
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    “‘Treatment’ generally means the provision, coordination, or management of health care and related services among health care providers or by a health care provider with a third party, consultation between health care providers regarding a patient, or the referral of a patient from one health care provider to another.”; “A covered entity may disclose protected health information for the treatment activities of any health care provider (including providers not covered by the Privacy Rule).”.
27. U.S. Department of Health and Human Services, Office of Inspector General. Fraud & Abuse Laws (A Roadmap for New Physicians, the Anti-Kickback Statute). Checked October 23, 2026.
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    “The AKS is a criminal law that prohibits the knowing and willful payment of ‘remuneration’ to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal health care programs (e.g., drugs, supplies, or health care services for Medicare or Medicaid patients). Remuneration includes anything of value”; “The statute covers the payers of kickbacks-those who offer or pay remuneration- as well as the recipients of kickbacks-those who solicit or receive remuneration.”.
28. Camacho M, Certal V, Abdullatif J, Zaghi S, Ruoff CM, Capasso R, Kushida CA. Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis (SLEEP. 2015;38(5):669–675. doi:10.5665/sleep.4652, PMID 25348130; passages from the abstract). Checked October 23, 2026.
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    “Nine adult studies (120 patients) reported polysomnography, snoring, and/or sleepiness outcomes.”; “Two pediatric studies (25 patients) reported outcomes.”; “Myofunctional therapy could serve as an adjunct to other obstructive sleep apnea treatments.”.
29. Felício CM, Ferreira CL. Protocol of orofacial myofunctional evaluation with scores (International Journal of Pediatric Otorhinolaryngology. 2008;72(3):367–375. doi:10.1016/j.ijporl.2007.11.012, PMID 18187209; passages from the abstract). Checked October 23, 2026.
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    “The proposal of this study is to describe a protocol for the evaluation of children aged 6-12 years in order to establish relations between the orofacial myofunctional conditions and numerical scales.”; “The clinical conditions included were: appearance, posture and mobility of lips, tongue, cheeks and jaws, respiration, mastication and deglutition.”; “The OMES protocol proved to be a valid and reliable instrument for orofacial myofunctional evaluation, permitting the grading of orofacial myofunctional conditions within the limits of the selected items.”.
30. Bakke M, Bergendal B, McAllister A, Sjögreen L, Asten P. Development and evaluation of a comprehensive screening for orofacial dysfunction (Swedish Dental Journal. 2007;31(2):75–84. PMID 17695052; passages from the abstract). Checked October 23, 2026.
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    “The Nordic Orofacial Test--Screening (NOT-S), consisting of a structured interview and clinical examination,was developed with a picture manual illustrating the different tasks in the examination.”; “The mean NOT-S score (+/- SD) in 120 patients (3-86 yr), referred to five centers for specialized dental care or speech and language pathology in Sweden, Norway and Denmark, was 4.1 +/- 2.6, and 0.4 +/- 0.6 in 60 control subjects (3-78 yr).”; “the sensitivity of the screening was 0.96 and specificity 0.63.”.
31. American Speech-Language-Hearing Association. Coding for Reimbursement Frequently Asked Questions: Speech-Language Pathology (ASHA coding FAQ). “The procedure code for a clinical swallowing evaluation is CPT 92610.”; “Payers may have documentation requirements of their own, including the information they want to see when reviewing a claim and the timelines in which documentation must be submitted.”. Checked October 23, 2026.
32. American Speech-Language-Hearing Association. Treatment Code Family Replacing 92507 (ASHA coding guidance on the code family effective January 1, 2027). Checked October 23, 2026.
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    “Clinicians should select the code that most accurately describes the disorder or condition being treated, the services provided, and the amount of direct, one-on-one patient contact during the session.”; “92656”; “Treatment of speech sound production disorder (eg, articulation, phonological process, apraxia, dysarthria), direct (one-on-one) patient contact; initial 30 minutes”; “+92657”; “each additional 15 minutes (list separately in addition to code for primary service)”.
33. American Speech-Language-Hearing Association. Medicare CPT Coding Rules for Speech-Language Pathology Services (ASHA coding guidance, Table 1). Checked October 23, 2026.
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    “92522”; “Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);”; “Don’t bill 92522 in conjunction with 92523.”; “92523”; “Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)”; “92526”; “Treatment of swallowing dysfunction and/or oral function for feeding”; “92610”; “Evaluation of oral and pharyngeal swallowing function”.
34. Aetna. Speech Therapy (Medical Clinical Policy Bulletin 0243, last review May 13, 2026). Checked October 23, 2026.
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    “Treatment of communication disabilities and/or swallowing disorders (dysphagia) from disease when all of the following criteria are met:”; “The member’s physician has determined that the member’s condition can improve significantly with speech therapy”; “Speech therapy services must be provided in accordance with an ongoing, written plan of care that is reviewed with and approved by the treating physician in accordance with applicable state laws and regulations.”; “procedures that may be carried out effectively by the member, family, or caregivers at home on their own”; “Speech therapy is considered not medically necessary for dysfunctions that are self-correcting, such as language therapy for young children with natural dysfluency or developmental articulation errors that are self-correcting”.
35. Aetna. Obstructive Sleep Apnea in Adults (Medical Clinical Policy Bulletin 0004, last review October 6, 2026). “The following surgeries and procedures are considered experimental, investigational, or unproven for the treatment of OSA because its effectiveness has not been established:”; “Respiratory muscle therapy (i.e., breathing exercises, oropharyngeal exercises, and wind musical instruments)”. Checked October 23, 2026.
36. Electronic Code of Federal Regulations. 42 CFR 424.24, Requirements for medical and other health services furnished by providers under Medicare Part B (paragraph (c), outpatient physical therapy, occupational therapy, and speech-language pathology services). Checked October 23, 2026.
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    “The services were furnished while the individual was under the care of a physician, nurse practitioner, clinical nurse specialist, or physician assistant.”; “If the plan of treatment is established by a physical therapist, occupational therapist, or speech-language pathologist, the certification must be signed by a physician or by a nurse practitioner, clinical nurse specialist, or physician assistant who has knowledge of the case”; “Recertification is required at least every 90 days.”.
37. Federal Trade Commission. Advertising FAQ’s: A Guide for Small Business (FTC business guidance). Checked October 23, 2026.
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    “Although the FTC has jurisdiction over ads for most products and services”; “In most cases, ads that make health or safety claims must be supported by ‘competent and reliable scientific evidence’ - tests, studies, or other scientific evidence that has been evaluated by people qualified to review it.”; “Statements from satisfied customers usually are not sufficient to support a health or safety claim or any other claim that requires objective evaluation.”.
38. Federal Trade Commission. Health Products Compliance Guidance (FTC staff guidance, December 2022). Checked October 23, 2026.
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    “the same legal principles apply to the marketing of any health-related product.”; “As a general matter, substantiation of health-related benefits will need to be in the form of randomized, controlled human clinical testing to meet the competent and reliable scientific standard.”; “Epidemiological or observational studies can be valuable to show an association between a product or ingredient, but they don’t prove a causal link.”; “A magazine ad for nasal strips claims that nightly application will reduce the sound of snoring. The advertiser has competent and reliable scientific evidence that the strips substantially reduce the sound of snoring but not that they treat sleep apnea, a potentially life-threatening condition for which snoring is a primary symptom. The ad would be deceptive if it fails to adequately disclose that the nasal strips aren’t intended to treat sleep apnea.”.
39. Electronic Code of Federal Regulations. 45 CFR 164.508, Uses and disclosures for which an authorization is required (paragraph (a)(3), marketing). Checked October 23, 2026.
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    “a covered entity must obtain an authorization for any use or disclosure of protected health information for marketing, except if the communication is in the form of: (A) A face-to-face communication made by a covered entity to an individual; or (B) A promotional gift of nominal value provided by the covered entity.”.
40. Federal Trade Commission. Rule on the Use of Consumer Reviews and Testimonials, 16 CFR Part 465 (89 FR 68077, August 22, 2024). Checked October 6, 2026.
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    §465.4: it is unfair or deceptive for a business “to provide compensation or other incentives in exchange for, or conditioned expressly or by implication on, the writing or creation of consumer reviews expressing a particular sentiment, whether positive or negative”; §465.2(d): the purchased- and insider-review provisions do not apply to “generalized solicitations to purchasers to post reviews or testimonials about their experiences”; §465.5: an officer or manager who writes a review of their own business must clearly disclose the relationship; §465.7: no one may use “an unfounded or groundless legal threat, a physical threat, intimidation, or a public false accusation” to stop a review or have it removed. Text as published in the eCFR.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. It is general guidance on running a therapy practice, not legal, compliance, billing or financial advice. It does not decide whether to treat, refer or bill any client; coverage and coding rules differ by payer and change, so confirm them with each payer.