How to start a speech-language pathology private practice

Start an SLP private practice by choosing the communication or swallowing services you can actually deliver, defining the population and setting, verifying licensure, business and payer requirements, and preparing the clinical and administrative workflow. Pediatric and adult services need separate service descriptions and separate access assumptions.

Do not launch a broad “speech therapy for everyone” offer without confirming its clinical and practical basis. The sections below follow the order of the work: the service inventory, access for children and adults, licensure, the business, Medicare and other payers, evaluation and records, money, referrals, a test run and the opening checklist.

What are the steps to start a speech therapy private practice?

Start with the services and the people they are for, and leave promotion until a test inquiry has gone through every step. Each step below has its own section in this guide.

1. Inventory the services. List each evaluation and service the clinicians can deliver now, with population, setting, equipment and exclusions.
2. Plan access by population. Write the pediatric route and the adult route separately, including how people with communication disabilities reach you.
3. Confirm licensure. Hold an active license where you practice and, for telepractice, where each client is located.
4. Set up the business. Structure, registration, EIN, bank account and insurance, recorded in a requirements register.
5. Decide on payers. Get an NPI, decide on Medicare enrollment and start the applications for the plans you intend to join.
6. Build evaluation and records processes. Define the service-fit review, the medical coordination route and the record system.
7. Budget on real capacity. Count preparation, documentation and coordination time before counting bookable hours.
8. Introduce, test, then open. Write the referral introduction, run test inquiries and fix the first broken step.

Which speech-language services should a new private practice offer?

Offer only the services your clinicians are competent and equipped to provide today, listed one by one rather than as the profession’s full scope. Create an inventory of evaluation and service capabilities. For each offering, record clinician competence, population, setting, equipment, medical coordination where relevant, and exclusions.

ASHA defines the SLP as the professional who practices in communication and swallowing across the life span, and its scope document distinguishes that breadth from individual competence: an SLP typically does not practice in all areas, and practices only where competent by education, training and experience.⁠¹ Pediatric communication services, adult acquired language services, voice, fluency, cognitive communication, AAC, and swallowing offerings can involve different processes. Advertise only the actual service.

Do not imply that a clinic provides instrumental swallowing assessments or every AAC service because an SLP is on staff. A narrow, accurate list is easier to deliver than a menu of every area in the scope.

Do you need a specialty certification to offer a speech service?

No specialty certification is required to practice in an area of the scope, but competence is. ASHA states that specialty certification is not required to practice in any area of the speech-language pathology scope, and it recognizes specialty boards in child language, fluency, swallowing and AAC, among others.⁠⁵ Its scope document still limits practice to areas where the clinician is competent.⁠¹ Record the training and experience behind each listed service, so the inventory is something a referrer or a payer could check.

Can a new SLP practice offer swallowing evaluations?

It can offer what its clinicians and setting support, and it should describe exactly that. ASHA notes that verifying aspiration requires an instrumental assessment, that the videofluoroscopic swallowing study is a radiographic procedure, and that the flexible endoscopic evaluation of swallowing is portable and can be done in outpatient clinic space.⁠⁶ No special certification is required for either, but ASHA expects appropriate training and demonstrated competency, and some state regulators may require a radiologist to be present for the radiographic study.⁠⁶

A practice without its own instrumental studies can still evaluate and treat within its competence, provided the public description says how instrumental studies are arranged and does not promise a swallowing-safety determination from an inquiry.

How should an SLP practice plan pediatric and adult access?

Plan the two routes separately, because the person who makes contact, the scheduling limits and the communication needs differ. For children, confirm actual ages, caregiver participation, setting, scheduling windows, and appropriate coordination with other services. For adults, address the patient directly and plan supported communication routes. A telephone-only inquiry can be difficult for the population an adult SLP service seeks to serve.

For young and school-age children, coordination can involve public programs as well. Under IDEA, early intervention serves children under three who need it, including for a delay in communication development, and a free appropriate public education must be available to children from 3 through 21.⁠^7,8 An outpatient practice does not decide either kind of eligibility, so the pediatric intake should ask what services a child already receives and explain how the practice coordinates, as families read on pages like early intervention versus private therapy.

Decide how a helper participates without assuming legal authority or transferring every decision away from the adult. HHS notes that a provider is not required to share information with family or friends unless they are personal representatives, and that an adult’s personal representative is a person with legal authority to make health care decisions, such as a health care power of attorney.⁠^9,10 Prepare the relevant verification and communication procedures through the qualified practice process. Adults reading about speech therapy for adults should find the same route on your own site.

How do adults with communication disabilities contact a new practice?

They should be able to reach you in more than one way, and the practice should be ready for each. The ADA requires businesses that serve the public to communicate effectively with people who have communication disabilities, using auxiliary aids and services when needed; for speech disabilities that can mean simply taking more time with someone who uses a communication board.⁠⁴ The relay service reached by dialing 7-1-1 offers speech-to-speech transliteration, and a practice cannot require a person to bring someone to interpret for them.⁠⁴

• Offer at least one written route, such as email or a form, alongside the phone.
• Train whoever answers the phone to slow down, check understanding and offer a written follow-up.
• Ask every caller whether they need any assistance or a particular way of communicating, and record the answer.
• Reply to the adult, through the route they chose, unless they direct otherwise.

The accessible inquiry form guide covers the written route in detail.

What licenses does a speech-language pathology practice need?

You need state authorization to practice in each state where you provide services, and for telepractice that includes the client’s state. Medicare, for one, requires an SLP in private practice to be legally authorized by the state in which they practice, and to practice only within that license.⁠¹¹ ASHA advises clinicians to verify licensure requirements both in the state from which they provide services and in the state where the client receives them, before services start.⁠²

If you plan telehealth, review authorization and patient-location questions before announcing broad geographic availability. A video platform’s availability does not establish that a clinician may provide every service to every location. ASHA also asks clinicians to weigh whether particular goals need in-person service, such as tactile cueing, device programming or feeding and swallowing work, and expects telepractice to be of equal quality to in-person care.⁠²

Can an SLP treat clients in other states through the ASLP-IC?

Only in states where compact privileges are being issued and only once you hold one. The compact commission reports that 37 jurisdictions have enacted the Audiology and Speech-Language Pathology Interstate Compact, with registration open to licensed practitioners in Louisiana, Ohio, Tennessee and West Virginia.⁠¹² Under the compact, practice occurs where the patient or client is located at the time of the encounter.⁠¹² Until a privilege is issued for a state, a license in that state is the route.

How do you set up the business side of an SLP private practice?

Choose the structure, register it, get an EIN, open a business account and buy insurance, and record each requirement with its source. Maintain a register for professional authorization, business structure, local requirements, insurance, records, privacy and security, and payer arrangements. Use the actual jurisdiction and service setting.

General business guidance is available through the SBA, but it does not replace profession-specific requirements. It notes that the structure affects taxes, liability and paperwork, that registration usually costs less than $300 depending on the state and structure, and that the EIN is free.⁠¹³ Apply for the EIN directly with the IRS, after forming any LLC or corporation with the secretary of state.⁠¹⁴ The SBA also lists professional liability insurance, which covers losses from malpractice, errors and negligence, for businesses that provide services.⁠¹³

State law can limit the structure. California’s Corporations Code does not let an LLC render professional services, defined as services lawfully rendered only under a license from the Business and Professions Code, and it provides for a speech-language pathology corporation instead.⁠^15,16,17 Confirm the permitted structure for your state with an attorney before filing.

Do speech therapists in private practice have to accept Medicare?

Not if they never see Medicare patients, but an SLP who wants to treat them must enroll. ASHA explains that SLPs in private practice who want to work with Medicare patients must enroll, cannot opt out of Medicare or make private-pay arrangements with Medicare patients, and must repay patients for covered services provided without enrolling.⁠³ CMS lists qualified speech-language pathologists among providers who are not eligible to opt out.⁠¹⁸

SLPs in private practice have been able to bill Medicare directly since July 1, 2009.⁠¹⁹ To do so, the SLP bills only for services furnished in the practice’s office space or the patient’s home, and office space must be owned, leased or rented by the practice and used for the exclusive purpose of operating it.⁠¹¹ Services are covered when a physician or NPP certifies the plan of care, initially within 30 calendar days of the first treatment day.⁠²⁰

Enrollment starts with an NPI, which does not show licensure or credentialing and does not enroll anyone in a health plan, and continues in PECOS with your Medicare Administrative Contractor.⁠^21,22 For commercial plans and Medicaid, the credentialing guide separates application status from a verified participation statement.

How does the Medicare therapy threshold apply to speech therapy?

For 2026, the threshold is $2,480 for PT and SLP services combined: once a patient’s services pass it, claims must carry the KX modifier confirming medical necessity as documented in the record, and claims over the threshold without it are denied.⁠²³ Because PT and SLP share one amount, a patient who also receives physical therapy during the year reaches the threshold sooner, which matters for documentation and for the revenue forecast.⁠²³

Can a speech therapist bill Medicare for telehealth?

Yes, for now. ASHA reports that SLP services covered under telehealth since 2020 became permanent Medicare telehealth services on January 1, 2026, and that Congress extended SLPs’ authority to furnish them through December 31, 2027; CMS reports the same extension for PTs, OTs and SLPs.⁠^23,24 Licensure still depends on where the client is located, so the telehealth service area is the list of states where the clinician is authorized.⁠²

What evaluation and documentation processes does an SLP practice need?

Define who reviews service fit, how clinical information arrives and who owns each record, before the first evaluation is booked. Define the service-fit review and the route for necessary clinical information. Explain the evaluation without promising a diagnosis, improvement, visit count, or swallowing-safety determination from an inquiry.

For services involving medical coordination, identify the professional contact route and what information the clinician needs. Keep clinical review distinct from the administrative task of collecting documents. A referral does not automatically confirm the setting or assessment capability. ASHA notes that SLP services are not prescribed by another professional, but that some settings and payers require a prescription or specific eligibility criteria, so the payment route and the clinical route both belong in the intake record.⁠¹

Select tools after reviewing their actual use and information flow. Templates should support clinical work, not substitute for individualized assessment or encourage documentation that does not reflect the service provided. A practice that transmits health information electronically in a HIPAA standard transaction is a covered entity, and it needs a written business associate agreement with any vendor that holds client information for it, such as a record-system or cloud provider.⁠^25,26

How do you budget an SLP practice around real capacity?

Budget on the hours the practice can actually fill and collect, not on a full calendar. Obtain actual startup and monthly cost information for the setting, equipment, systems, insurance, and administrative support. Reserve time for preparation, records, coordination, and follow-up rather than treating every working hour as a bookable appointment.

Use conservative collection scenarios. Pediatric school-hour demand and adult work or transport constraints may make some nominal openings unusable. If a payer application is pending, do not forecast those collections as approved contracted revenue. Cash also arrives after the visit: Medicare cannot pay a clean electronic claim before the 14th day after it arrives.⁠²⁷

For a self-pay client, the No Surprises Act requires a good faith estimate of expected charges when the client schedules at least three days ahead or asks for one, and recurring services can be covered by a single estimate.⁠²⁸ The startup worksheet separates one-time costs from cash runway, and the credentialing guide separates application status from a verified participation statement.

How do you introduce a new SLP practice to referral sources?

Send a short, service-specific introduction to contacts whose patients match the actual service. Write a short introduction stating the actual services, population, setting, clinician qualifications, referral route, and capacity statement. For a pediatric service, choose relevant child-service contacts. For an adult service, select medical or rehabilitation contacts relevant to the actual offering.

Do not include patient stories, referral incentives, or reciprocal volume promises. Where Medicare or Medicaid business is involved, OIG explains that the Anti-Kickback Statute makes it a crime to knowingly and willfully pay remuneration, which includes anything of value, to induce or reward referrals.⁠²⁹ The useful commitment is a clear review and handoff process. Use the adult SLP growth guide or the speech therapy client guide for the appropriate pathway, and the adult referral guide for discharge handoffs.

How do you test an accessible SLP launch workflow?

Run three test inquiries, each through a different route, and check what the person is told, who receives the request and what happens next. Test a caregiver inquiry, an adult inquiry with a communication preference, and a referral requiring clinical review. Use administrative test information and check what the visitor is told, who receives the request, and which next action occurs.

1. A caregiver inquiry. A parent writes about a preschooler’s speech. Does the reply ask about current early intervention or school services and explain the evaluation without promising a diagnosis?
2. An adult inquiry with a communication preference. An adult with aphasia asks, by email, to be contacted in writing. Does every later message arrive in writing, addressed to the adult?
3. A referral needing clinical review. A physician’s office sends a swallowing referral. Does the clinician review it before anyone schedules, and does the referrer hear how instrumental studies are handled?

What should an SLP practice confirm before opening day?

Confirm that the public description and the actual operation agree, item by item. Do not declare launch complete solely because the website is live.

Complete the service inventory and test communication access. Use the 90-day marketing plan only after the advertised workflow is ready.

Sources

1. American Speech-Language-Hearing Association. Scope of Practice in Speech-Language Pathology (2016). The SLP “engages in professional practice in the areas of communication and swallowing across the life span”; “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.” Checked October 8, 2026.
2. American Speech-Language-Hearing Association. Telepractice (Practice Portal). “Clinicians should verify state licensure/certification requirements in the state from which the clinician provides services as well as the state in which the client receives services prior to initiating services”; “Use of telepractice should be of equal quality to in-person services”; clinicians consider “whether specific goals require in-person service (e.g., tactile cueing, device programming, feeding/swallowing).” Checked October 8, 2026.
3. American Speech-Language-Hearing Association. A Guide to Mandatory Medicare Enrollment for Audiologists and SLPs in Private Practice (December 5, 2025). “Audiologists and speech-language pathologists (SLPs) in private practice who want to work with Medicare patients must enroll in Medicare. Unlike some other health care providers (like physicians), audiologists and SLPs cannot ‘opt out’ of Medicare or enter into private pay arrangements with Medicare patients”; “If audiologists and SLPs provide services to Medicare patients without enrolling in Medicare, they must repay the patient for any covered services provided—and in some cases, they may face additional financial penalties.” Checked October 8, 2026.
4. U.S. Department of Justice, Civil Rights Division. ADA Requirements: Effective Communication (ADA.gov; last updated February 28, 2020). Title III entities, “businesses and nonprofit organizations that serve the public,” must “communicate effectively with people who have communication disabilities”; “Covered entities must provide auxiliary aids and services when needed to communicate effectively with people who have communication disabilities”; for people with speech disabilities this may include “just taking more time to communicate with someone who uses a communication board”; the relay service reached by calling 7-1-1 “also provides speech-to-speech transliteration for callers who have speech disabilities”; covered entities “cannot require a person to bring someone to interpret for him or her.” Checked October 8, 2026.
5. American Speech-Language-Hearing Association. Clinical Specialty Certification. “Specialty certification is not required to practice in any area within the Audiology or Speech-Language Pathology Scopes of Practice”; specialty certification is available through the American Audiology Board of Intraoperative Monitoring, the American Board of Augmentative and Alternative Communication, the American Board of Child Language and Language Disorders, the American Board of Fluency and Fluency Disorders and the American Board of Swallowing and Swallowing Disorders. Checked October 8, 2026.
6. American Speech-Language-Hearing Association. Adult Dysphagia (Practice Portal). “Verification of aspiration and thorough assessment of impairments in swallowing physiology or laryngeal/pharyngeal/upper esophageal anatomy require instrumental assessment”; SLPs “typically use one of two types of instrumental evaluation: the videofluoroscopic swallowing study (VFSS) or the flexible endoscopic evaluation of swallowing (FEES)”; the VFSS “is a radiographic procedure”; “The FEES is a portable procedure that may be completed in outpatient clinic space or at bedside”; “SLPs do not require special certification from any entity to perform instrumental assessments. However, per the ASHA Code of Ethics, SLPs should have appropriate training and demonstrate competency before completing instrumental techniques”; “other parties (e.g., state regulatory agencies) may require a radiologist to be present during the VFSS.” Checked October 8, 2026.
7. Code of Federal Regulations. 34 CFR 303.21, Infant or toddler with a disability (IDEA Part C). eCFR text, current as of the September 29, 2026 issue. “Infant or toddler with a disability means an individual under three years of age who needs early intervention services” because of a developmental delay, including in communication development, or a diagnosed condition with a high probability of resulting in delay. Checked October 8, 2026.
8. Code of Federal Regulations. 34 CFR 300.101, Free appropriate public education (FAPE) (IDEA Part B). eCFR text, current as of the September 29, 2026 issue. “A free appropriate public education must be available to all children residing in the State between the ages of 3 and 21, inclusive.” Checked October 8, 2026.
9. U.S. Department of Health and Human Services, Office for Civil Rights. Family Members and Friends (HIPAA for Individuals; content last reviewed December 23, 2022). “The Privacy Rule does not require a health care provider or health plan to share information with your family or friends, unless they are your personal representatives”; a provider can share it if family or friends “are involved in your health care or payment for your health care,” if “You tell the provider or plan that it can do so,” if “You do not object,” or if, “using its professional judgment, a provider or plan believes that you do not object.” Checked October 8, 2026.
10. U.S. Department of Health and Human Services, Office for Civil Rights. Personal Representatives (HIPAA Privacy Rule guidance, 45 CFR 164.502(g); content last reviewed January 5, 2024). For an adult, the personal representative is “A person with legal authority to make health care decisions on behalf of the individual,” such as a health care power of attorney or a court-appointed legal guardian; “In most cases under the Rule, a parent, guardian, or other person acting in loco parentis (collectively, ‘parent’) is the personal representative of the minor child”; the exceptions “generally track the ability of certain minors to obtain specified health care without parental consent under State or other laws.” Checked October 8, 2026.
11. Code of Federal Regulations. 42 CFR 410.62, Outpatient speech-language pathology services: Conditions and exclusions. eCFR text, current as of October 6, 2026. An SLP in private practice must “Be legally authorized (if applicable, licensed, certified, or registered) to engage in the private practice of speech-language pathology by the State in which he or she practices”; practice “on a regular basis as an individual, in one of the following practice types: a solo practice, partnership, or group practice; or as an employee of one of these”; and bill Medicare only for services in private practice office space, which “must be owned, leased, or rented by the practice, and used for the exclusive purpose of operating the practice,” or in “A patient’s home not including any institution that is a hospital, a CAH, or a SNF.” Checked October 8, 2026.
12. Audiology & Speech-Language Pathology Interstate Compact Commission. ASLP-IC. “At this time, 37 jurisdictions (36 states and 1 territory) have enacted ASLP-IC legislation”; “Registration for compact privileges to practice is open for licensed practitioners in Louisiana, Ohio, Tennessee, and West Virginia”; “Practice of audiology and speech-language pathology occurs in the state where the patient/client is located at the time of the patient/client encounter.” Checked October 8, 2026.
13. U.S. Small Business Administration. Launch your business. “Your business structure affects how much you pay in taxes, your ability to raise money, the paperwork you need to file, and your personal liability”; “members of an LLC are considered self-employed and must pay self-employment tax contributions towards Medicare and Social Security”; “In most cases, the total cost to register your business will be less than $300, but fees vary depending on your state and business structure”; “It’s free to apply for an EIN”; a physical location should conform “to local zoning requirements,” and “zoning ordinances can still apply even to home-based businesses”; “The licenses and permits you need from the state, county, or city will depend on your business activities and business location”; “Some licenses and permits expire after a set period of time”; “The federal government requires every business with employees to have the following”: workers’ compensation, unemployment and disability insurance, and “Laws requiring insurance vary by state”; professional liability insurance “protects against financial loss as a result of malpractice, errors, and negligence”; “As soon as you start accepting or spending money as your business, you should open a business bank account”; “Business banking offers limited personal liability protection by keeping your business funds separate from your personal funds.” Checked October 8, 2026.
14. Internal Revenue Service. Get an employer identification number (page last reviewed or updated August 19, 2026). “Use this tool to get an EIN directly from the IRS in minutes for free”; “You never have to pay a fee for an EIN”; “If you are creating a corporation or LLC, form your entity through the secretary of state before you apply for an EIN.” Checked October 8, 2026.
15. California Legislative Information. California Corporations Code §17701.04. Subdivision (e): “Nothing in this title shall be construed to permit a domestic or foreign limited liability company to render professional services, as defined in subdivision (a) of Section 13401 and in Section 13401.3, in this state.” Checked October 8, 2026.
16. California Legislative Information. California Corporations Code §13401. “‘Professional services’ means any type of professional services that may be lawfully rendered only pursuant to a license, certification, or registration authorized by the Business and Professions Code, the Chiropractic Act, or the Osteopathic Act.” Checked October 8, 2026.
17. California Legislative Information. California Corporations Code §13401.5. Designates, among others, a “Speech-language pathology corporation,” a “Physical therapy corporation” and an “Occupational therapy corporation,” and lists the other licensed persons who may hold shares in each, “so long as the sum of all shares owned by those licensed persons does not exceed 49 percent of the total number of shares.” Checked October 8, 2026.
18. Centers for Medicare & Medicaid Services. Manage Your Enrollment (page last modified March 4, 2026). “Physicians and practitioners who see Medicare patients but don’t want to enroll in the Medicare program must opt-out of Medicare”; “If you don’t see Medicare patients, you don’t have to enroll in or opt-out of Medicare”; the list of “Providers NOT Eligible to Opt Out” includes “Occupational therapists,” “Physical therapists” and “Qualified speech language pathologists.” Checked October 8, 2026.
19. American Speech-Language-Hearing Association. Medicare and Speech-Language Pathologists in Private Practice. The Medicare Improvements for Patients and Providers Act of 2008 included “a provision that will allow speech-language pathologists in private practice to directly bill the Medicare program effective July 1, 2009.” Checked October 8, 2026.
20. Centers for Medicare & Medicaid Services. Complying with Outpatient Rehabilitation Therapy Documentation Requirements (MLN Fact Sheet MLN905365, September 2025). Outpatient PT, OT and SLP services are covered when the “Physician or NPP certifies the treatment plan, also called the plan of care (POC)”; “The physician or NPP certifies the initial POC with a dated signature or verbal order within 30 calendar days from the first day of treatment, including evaluation”; recertification comes “at least every 90 calendar days after treatment starts”; from January 1, 2025, a physician’s or NPP’s dated signature on the order or referral may substitute for a signature on the initial POC that has not been returned within 30 calendar days of the initial evaluation. Checked October 8, 2026.
21. Centers for Medicare & Medicaid Services. NPI Fact Sheet (December 2024). Type 1 NPIs are “For individual health care providers, such as physicians, nurse practitioners and sole proprietors. Individuals are only eligible for one NPI”; Type 2 are “For health care organizations”; “An individual who is a health care provider and is incorporated, can obtain an NPI for themselves (Type 1) and an NPI for their corporation or LLC (Type 2)”; “Having an NPI does not: Ensure a provider is licensed or credentialed; Guarantee payment by a health plan; Enroll a provider in a health plan”; “you must report any changes to the information provided for your NPI within 30 days of the change”; “A provider or supplier will not receive payment from Medicare until it is properly certified and enrolled in the Medicare program.” Checked October 8, 2026.
22. Centers for Medicare & Medicaid Services. Become a Medicare Provider or Supplier (page last modified June 2, 2026). The four steps: “Get an NPI”; “Complete the Medicare Enrollment Application” in PECOS; “Pay the Medicare Application Fee, if applicable”; “Work With Your MAC.” A change in ownership, an adverse legal action or a change in practice location is reported within 30 days; “You must report all other changes within 90 days.” Checked October 8, 2026.
23. Centers for Medicare & Medicaid Services. Therapy Services (page last modified March 10, 2026). The law keeps the former therapy cap amounts “as thresholds above which claims must include the KX modifier as a confirmation that services are medically necessary as justified by appropriate documentation in the medical record,” with “one amount for PT and SLP services combined and a separate amount for OT services”; “For CY 2026 this KX modifier threshold amount is: $2,480 for PT and SLP services combined, and $2,480 for OT services”; “Claims for services over the KX modifier threshold amounts without the KX modifier are denied”; section 6209 of the Consolidated Appropriations Act, 2026 “extended the ability of PTs, OTs, and SLPs to furnish Telehealth Services … through December 31, 2027”; for PT and OT services furnished in whole or in part by PTAs and OTAs, “Payment for these services is at 85 percent of the otherwise applicable PFS payment amount/rate for the service, effective January 1, 2022.” Checked October 8, 2026.
24. American Speech-Language-Hearing Association. Providing Audiology and Speech-Language Pathology Telehealth Services Under Medicare (updated February 3, 2026). The Consolidated Appropriations Act, 2026 “includes an extension of Medicare telehealth authority for audiologists and SLPs through December 31, 2027”; “all audiology and speech-language pathology services that have been covered under telehealth since 2020 are permanently covered as authorized telehealth services starting January 1, 2026.” Checked October 8, 2026.
25. U.S. Department of Health and Human Services, Office for Civil Rights. Covered Entities and Business Associates (content last reviewed August 21, 2024). Health care providers are covered entities “but only if they transmit any information in an electronic form in connection with a transaction for which HHS has adopted a standard”; “If a covered entity engages a business associate to help it carry out its health care activities and functions, the covered entity must have a written business associate contract or other arrangement with the business associate.” Checked October 8, 2026.
26. U.S. Department of Health and Human Services, Office for Civil Rights. Business Associates (content last reviewed July 30, 2026). Examples of business associates include a “Cloud service provider engaged to create, receive, maintain, or transmit electronic PHI (ePHI)” and an “IT contractor or vendor (e.g., EHR vendor, Managed Services Provider) that provides maintenance and/or support services” for systems holding ePHI; “A business associate is also directly liable for complying with certain provisions of the HIPAA Rules.” Checked October 8, 2026.
27. Centers for Medicare & Medicaid Services. Medicare Claims Processing Manual, Chapter 1, General Billing Requirements (Rev. 13725, issued April 10, 2026), §§80.2.1.1–80.2.1.2. “‘Clean’ claims must be paid or denied within the applicable number of days from their receipt date,” 30 days for claims received from October 1, 1993; the payment floor “establishes a waiting period during which time the contractor may not pay, issue, mail, or otherwise finalize the initial determination on a clean claim,” with the earliest payment on the “14th day for HIPAA-compliant EMC” and the “29th day for paper.” Checked October 8, 2026.
28. Centers for Medicare & Medicaid Services. Decision Tree: Requirements for Good Faith Estimates for Uninsured (or Self-Pay) Individuals (revision date September 2023). “Beginning January 1, 2022, the No Surprises Act requires all health care providers and facilities to provide an estimate of expected charges within certain timeframes” to uninsured consumers and to “Consumers who have certain types of health coverage but do not intend to use it (also known as ‘self-pay’ individuals)”; it “must be provided when such consumer schedules a service at least 3 days in advance or requests an estimate”; a provider expecting recurring services may give “a single good faith estimate for those recurring items or services,” for example “counseling services or physical therapy”; the document “does not have the force and effect of law.” Checked October 8, 2026.
29. U.S. Department of Health and Human Services, Office of Inspector General. Fraud & Abuse Laws (A Roadmap for New Physicians). “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”; “Remuneration includes anything of value and can take many forms besides cash”; “in the Federal health care programs, paying for referrals is a crime.” Checked October 8, 2026.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. It is general guidance on starting and running a therapy practice, not legal, tax, compliance, billing or financial advice. Its numerical examples are hypothetical, not DrSensory data or industry benchmarks.