Insurance & Billing Information for Speech Therapy Services

At MCG, we bill medically based speech therapy services to your insurance as either an in-network or out-of-network provider. If your plan does not include out-of-network benefits, you have the option of self-pay rates for evaluations and treatment sessions.

How Insurance Coverage Works

We are happy to check your eligibility and benefits as a courtesy. However, please understand that:

• Coverage varies by insurer and by plan.

• Some plans cover speech therapy under medical benefits; others do not.

• Providers cannot always see full benefit details (copays, deductibles, & exclusions).

For these reasons, clients are responsible for confirming whether your specific policy covers speech therapy services before beginning care.

Your Out-of-Pocket Costs May Include:

• Deductible

• Copay

• Coinsurance

• Non-covered services

These amounts are determined by your plan and are charged directly by your insurance company, not by MCG.

Important Notice for Medicaid Clients

If you have Medicaid, you must be enrolled in a Managed Care Organization (MCO). Standard Medicaid does not cover outpatient speech therapy services.

Insurance Plans We Accept (Speech Therapy)

We are In-Network with:

• Sentara Health Plans

• Cigna

• Anthem Blue Cross Blue Shield (including HealthKeepers)

• Aetna

• Aetna Better Health of Virginia

• Medicare

• United Healthcare

• Humana

We are Out-of-Network with:

• Tricare (Certified Out-of-Network)

Understanding Referrals & Authorizations

Referrals

A referral is a written order from your physician that includes a diagnosis and recommends therapy. Many insurance plans require referrals to ensure that treatment is appropriate and medically necessary.

Authorizations

Some insurance plans require prior authorization for therapy.
Authorizations may be required:

• Before the evaluation,

• After the evaluation, or

• Before ongoing treatment sessions.

An authorization approves the service, but does not guarantee full coverage. You may still be responsible for deductibles, copays, or coinsurance.

Questions About Your Insurance?

Our team is here to help you understand your options and navigate your coverage.
Please reach out if you need assistance verifying benefits or understanding your financial responsibility.

Getting Started With Speech Therapy at MCG

Beginning services with Mindful Communication Group is simple. To ensure proper medical documentation and insurance compliance, please follow the steps below.

1. Referral From Your Physician

Depending on your insurance, a referral may be required before we can schedule your initial evaluation appointment.
If a referral is required, your provider must include:

• A documented diagnosis code
  (Example: F80.2 – Mixed Receptive-Expressive Language Disorder)

• A written request for evaluation and treatment

• The provider’s NPI number

2. Scheduling Your Initial Evaluation

Our administrative team will:

• Verify your insurance benefits

• Contact you to schedule your evaluation appointment

• Review what to expect at your first visit

3. Authorization (If Required by Your Insurance Plan)

Some insurance plans require prior authorization before therapy can begin.
If so, please note:

• Authorization approval can take up to 30 days

• We will not schedule follow-up therapy sessions until authorization is received

Our team will handle the authorization request for you and communicate any updates.

4. We’re Here to Help

Our goal is to make this process easy and transparent. If you have questions about referrals, scheduling, or insurance, our administrative team is here to support you every step of the way.

Most clients are scheduled within one week of receiving a physician referral, completing the required intake forms and insurance verification. Appointments are scheduled with the therapist who has open availability at the time, based on your location and preferred service format (in-person or virtual). Once your paperwork is received, our team will contact you promptly to offer the next available appointment.