Speech treatment code crosswalk

ASHA identifies January 1, 2027 as the effective date for the new family replacing 92507. Payer implementation dates can differ. This is a service-based reference, not a one-to-one conversion of every 92507 visit. ASHA transition overview · Payer implementation resources. Checked October 13, 2026.

Previously reported individual treatment	Service treated	New base code	Paired add-on code
92507	Fluency	92654	92655
92507	Speech sound production	92656	92657
92507	Language comprehension and expression	92658	92659
92507	Combined speech sound and language	92660	92661
92507	Voice, upper airway dysfunction or resonance	92662	92663

Base codes describe an initial 30 minutes; paired add-ons describe additional 15-minute periods. Choose the service actually treated. Use combined speech and language codes when both areas are treated, rather than separate speech and language codes together. Add-ons require their corresponding base code. ASHA code guidance.

Time reference

Direct treatment time under the CPT midpoint convention	General reporting pattern
Under 16 minutes	Do not report this service separately
16–37 minutes	One base unit
38–52 minutes	One base unit plus one paired add-on unit
53–67 minutes	One base unit plus two paired add-on units

Payer timing and billing rules must be verified. This table does not convert authorized visits into units. The group code 92508 remains untimed with revised wording; it is separate from this individual-treatment crosswalk. ASHA treatment and timing guidance.

Authorization information by payer

Checked October 13, 2026. The routes below are supported by public payer pages. 2027 conversion not established means the reviewed material did not resolve existing 92507 approval conversion, base/add-on approval or remaining-unit preservation. It does not mean the payer has no guidance elsewhere.

Payer and exact product	Authorization route or published instruction	2027 authorization crosswalk status	Official source
BCBSIL BCCHP Medicaid	Check eligibility and the applicable code list; Carelon handles delegated requests. Carelon: 866-455-8415.	Not established; request code-specific conversion and unit rules.	BCBSIL PA instructions
BCBSIL commercial	Determine requirements and vendor from member benefits; HMO requests go through the medical group or IPA.	Not established; obtain the exact product and network rule.	BCBSIL PA instructions
Meridian Illinois Medicaid	Code-specific PA check; speech therapy is listed under Evolent vendor services.	Not established; confirm remaining visits, new code pairs and Evolent system handling.	Meridian service authorization
YouthCare HealthChoice Illinois	Use YouthCare-specific requirements; speech therapy is listed under Evolent vendor services.	Not established; verify separately from Meridian.	YouthCare service authorization
Aetna Better Health Illinois Medicaid	Clinical/payment policy questions: Medical Management via portal or 866-329-4701. Exact therapy PA requirement needs product/code verification.	Not established; request written new-code and existing-approval handling.	Illinois clinical and payment policies
Optum Physical Health delegated plans	Clinical submission forms and provider portal; identify the client payer and applicable delegation first.	Not established; current SLP criteria, existing-approval conversion and base/add-on rules need written plan-specific confirmation.	Optum clinical library · reimbursement library
Optum Medicare delegated therapy	Medicare Outpatient Skilled Therapy policy 497, effective February 11, 2026; verify the actual MA plan delegates review to Optum.	Not established; policy 497 does not itself establish 2027 authorization conversion or contracted rates.	Optum policy 497
VA Community Care Network / Optum	VA referral and authorization plus the Optum VA CCN portal route.	Verify the applicable referral, approved services, dates and code changes; commercial Optum rules are not substituted.	VA CCN

For the full roster—including Molina, CountyCare, Humana, HealthSpring, FEP, UMR and Allied—open Full plan policy libraries in Payor Policy Updates. Each map row includes policy documents or a clearly marked retrieval gap; authorization requirements and 2027 conversion must be confirmed for the exact product.

BCBSIL states that prior authorization does not guarantee payment. The approval, member benefits and applicable payment rules all need to align. Meridian’s page also lists EPSDT services among exceptions to pre-service review while listing Evolent therapy services; verify the exact pediatric service and code rather than assuming a universal requirement or exemption.

Existing authorization conversion checklist

Questions for a written payer response. These are information requests, not confirmed transition rules.

Conversion question	Record the payer’s exact answer
Existing 92507 approval extending into 2027	Automatic transfer, amendment or new request? Does the authorization number stay the same?
Approved quantity	Are approvals counted as visits, minutes, procedure units or a combined pool?
Base and add-on codes	Must each code be listed and separately approved? How are add-on units deducted?
Remaining approved care	Are unused visits/units and the original expiration date preserved?
Clinical documentation	Is a new evaluation, plan of care or updated diagnosis required solely because codes changed?
Implementation and transition dates	Which codes are accepted for which dates of service? Is any overlap period documented?
Claims matching and corrections	Which code, authorization number, modifiers and units must match? What is the correction route?
Accountable owner	Who can provide written authorization-policy and claims-system confirmation?

Authorization and payment crosswalk record

Use one record per payer, product, service and setting. Keep patient-level authorizations in the practice’s approved clinical system; this shared section records policy-level guidance.

Field	What to capture
Scope	Payer, product/network, Illinois applicability, setting and service
Code mapping	Old code; new base code; paired add-on; required modifiers
Authorization handling	Conversion method; existing approval validity; remaining quantity; expiration; new documentation
Unit handling	Approved unit definition; base/add-on limits; deduction method
Payment mapping	Base allowance; add-on allowance; fee schedule version; contract applicability
Timing	Publication/revision, effective date and claims-system implementation date
Evidence and status	Official notice or written payer response; exact section; last checked; verified, proposed or unknown
Follow-up	Responsible payer department; specific unanswered question; next check

Start by requesting written conversion instructions for existing approvals, then reconcile code and rate mapping with Billing Readiness. ASHA also provides a payer code-use tracker and template letter through its implementation resources.

Check code adoption, coverage, authorization, units, edits, documentation, rates and implementation separately. These dated working records retain their October 8–9, 2026 evidence checks; open items require plan-specific verification.

HFS Medicaid FFS

Record	Payer and scope	Status
r-9928144327	Illinois HFS · Medicaid FFS · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Published change: Sept 23 stuttering coverage; therapy fee schedule is the rate entry.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Published change: Sept 23 stuttering coverage; therapy fee schedule is the rate entry.
Next verification	Check J-200 revision and new-code fee schedule, GN/modifiers, pediatric units and authorization.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	Sept 23 stuttering coverage · therapy fee schedule
Source locator	## Illinois Medicaid and school programs → HFS Medicaid FFS

HFS School-Based Health Services

Record	Payer and scope	Status
r-ee50d60060	Illinois HFS · School Medicaid · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current schedule: school-based fee schedule effective Apr 1, 2026, updated Jul 21. This is a program, not an insurer.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current schedule: school-based fee schedule effective Apr 1, 2026, updated Jul 21. This is a program, not an insurer.
Next verification	Obtain school-specific code/unit instructions; do not apply outpatient clinic rules to IEP sessions.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	school-based fee schedule effective Apr 1, 2026, updated Jul 21
Source locator	## Illinois Medicaid and school programs → HFS School-Based Health Services

BCCHP

Record	Payer and scope	Status
r-006eb6f8f4	BCBSIL · Medicaid MCO · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Published change: Medicaid ID transition; HFS stuttering notice also covers HealthChoice MCOs.
Services	SLP
Last checked	2026-10-09
Dates	2026-11-16 Portal / EDI implementation; 2027-01-01 Member ID implementation
Verified reference	Published change: Medicaid ID transition; HFS stuttering notice also covers HealthChoice MCOs.
Next verification	Test RIN fields and confirm Carelon therapy authorization units and 2027 conversion.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Change	BCCHP Medicaid RIN becomes the sole member ID in all transactions January 1; Availity/EDI field changes November 16.
Date correction	The URL contains 9-24; the displayed publication date is September 25, 2026.
Option for Steph	Check RIN storage and eligibility/claim-status fields before November 16.
Source	Medicaid ID transition
Source locator	BCBSIL → Providers → News and Updates → Use Medicaid ID Instead of Subscriber ID → Affected transactions / Details to help you prepare

Aetna Better Health of Illinois

Record	Payer and scope	Status
r-cba436cf1b	Aetna · Illinois Medicaid MCO / Aetna Better Health · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current policy entry: IL clinical and payment policies; HFS stuttering notice applies.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current policy entry: IL clinical and payment policies; HFS stuttering notice applies.
Next verification	Ask for product-specific therapy PA, units and new-code handling; do not borrow Aetna commercial CPB as Medicaid rule.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	IL clinical and payment policies
Source locator	## Illinois Medicaid and school programs → Aetna Better Health of Illinois

Meridian Health Plan

Record	Payer and scope	Status
r-1f035a92ab	Meridian · Medicaid MCO · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current policy: physical, occupational and speech therapy CP.MP.49; state-fee/program tracker lists the HFS stuttering notice.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current policy: physical, occupational and speech therapy CP.MP.49; state-fee/program tracker lists the HFS stuttering notice.
Next verification	Check implementation date, Evolent/plan PA code list, and 2027 rate/authorization mapping.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	physical, occupational and speech therapy CP.MP.49 · state-fee/program tracker
Source locator	## Illinois Medicaid and school programs → Meridian Health Plan

YouthCare

Record	Payer and scope	Status
r-69b2f33382	YouthCare · Medicaid MCO · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current policy/PA entries: clinical policies and service authorization, which routes therapy to Evolent.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current policy/PA entries: clinical policies and service authorization, which routes therapy to Evolent.
Next verification	Verify foster-youth product rules and existing PA conversion separately from Meridian.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	clinical policies · service authorization
Source locator	## Illinois Medicaid and school programs → YouthCare

Molina Healthcare of Illinois · Medicaid

Record	Payer and scope	Status
r-4877dbcf44	Molina Illinois · Commercial / plan specific · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current reference: 2026 Medicaid provider manual and IL clinical policies.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current reference: 2026 Medicaid provider manual and IL clinical policies.
Next verification	Pull the current PA lookup and therapy manual section; check exact new codes and HFS coverage implementation.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	2026 Medicaid provider manual · IL clinical policies
Source locator	## Illinois Medicaid and school programs → Molina Healthcare of Illinois · Medicaid

CountyCare

Record	Payer and scope	Status
r-33ec7de37e	CountyCare · Medicaid MCO · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current PA entry: clinical criteria and authorization portal guidance. Cook County product.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current PA entry: clinical criteria and authorization portal guidance. Cook County product.
Next verification	Confirm therapy delegate, approved units and 2027 crosswalk only if serving a CountyCare member.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	clinical criteria · authorization portal guidance
Source locator	## Illinois Medicaid and school programs → CountyCare

BCBSIL commercial

Record	Payer and scope	Status
r-4a138b9a23	BCBSIL · Commercial / plan specific · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Published change: Jan 1 code/fee update.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Published change: Jan 1 code/fee update.
Next verification	Request code-specific PPO/Blue Choice allowances and PA/medical-policy mapping; compare both network contracts.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	Jan 1 code/fee update
Source locator	## Commercial and marketplace products → BCBSIL commercial

UHC commercial

Record	Payer and scope	Status
r-d1fc715195	UnitedHealthcare · Commercial / plan specific · National / plan specific	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current policies: speech reimbursement policy and habilitation/rehabilitation medical policy.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current policies: speech reimbursement policy and habilitation/rehabilitation medical policy.
Next verification	Verify timed units, same-day edits and new-code rates in the applicable commercial product.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	speech reimbursement policy · habilitation/rehabilitation medical policy
Source locator	## Commercial and marketplace products → UHC commercial

Aetna commercial

Record	Payer and scope	Status
r-b943e51c41	Aetna · Commercial / plan specific · National / plan specific	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current policy: Speech Therapy CPB 0243, with separate SGD 0437 and Dysphagia 0625.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current policy: Speech Therapy CPB 0243, with separate SGD 0437 and Dysphagia 0625.
Next verification	Compare developmental/habilitative, AAC and feeding cases to actual benefits; request 2027 code/unit/PA/rate guidance.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	Speech Therapy CPB 0243 · SGD 0437 · Dysphagia 0625
Source locator	## Commercial and marketplace products → Aetna commercial

Cigna Healthcare

Record	Payer and scope	Status
r-4d2d3fbda4	Cigna · Commercial / plan specific · National / plan specific	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current AAC policy: Speech Generating Devices 0049, effective Jan 15, 2026; policy index.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current AAC policy: Speech Generating Devices 0049, effective Jan 15, 2026; policy index.
Next verification	Separate device coverage from SLP treatment; ask for speech therapy and 2027 billing rules by product.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	Speech Generating Devices 0049, effective Jan 15, 2026 · policy index
Source locator	## Commercial and marketplace products → Cigna Healthcare

Molina Healthcare of Illinois · ACA

Record	Payer and scope	Status
r-0f1fd11774	Molina Illinois · Marketplace · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current product entry: Illinois marketplace provider resources.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current product entry: Illinois marketplace provider resources.
Next verification	Confirm ACA network, authorization and rates separately from Molina Medicaid.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	Illinois marketplace provider resources
Source locator	## Commercial and marketplace products → Molina Healthcare of Illinois · ACA

Ambetter of Illinois

Record	Payer and scope	Status
r-3e390b140a	Ambetter IL · Marketplace · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current policy: IL clinical/payment policies list CP.MP.49 for PT/OT/SLP.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current policy: IL clinical/payment policies list CP.MP.49 for PT/OT/SLP.
Next verification	Check the Illinois marketplace PA list and 2027 code/rate mapping; Centene policy does not itself establish contracted payment.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	IL clinical/payment policies
Source locator	## Commercial and marketplace products → Ambetter of Illinois

Oscar Health Plan of Illinois

Record	Payer and scope	Status
r-33232d3816	Oscar Illinois · Marketplace · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current entry: provider policies and PA list; Oscar lists 2026 Illinois plans.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current entry: provider policies and PA list; Oscar lists 2026 Illinois plans.
Next verification	Check member-specific network, telehealth and therapy PA before using new codes.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	provider policies · PA list · 2026 Illinois plans
Source locator	## Commercial and marketplace products → Oscar Health Plan of Illinois

Health Alliance / Carle Health

Record	Payer and scope	Status
r-94ba598890	Health Alliance · Commercial / plan specific · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current entry: clinical policy guidelines; regional product.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current entry: clinical policy guidelines; regional product.
Next verification	Confirm whether a family has this plan and request the speech policy, PA and code allowances for that product.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	clinical policy guidelines
Source locator	## Commercial and marketplace products → Health Alliance / Carle Health

MercyCare Health Plans

Record	Payer and scope	Status
r-1ecf86f503	MercyCare Illinois · Commercial / plan specific · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current entry: medical policies state the member plan determines coverage; Illinois large-group product includes speech therapy.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current entry: medical policies state the member plan determines coverage; Illinois large-group product includes speech therapy.
Next verification	Verify Illinois group/benefit terms. Do not use a Wisconsin 2027 benefit guide as Illinois evidence.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	medical policies · Illinois large-group product
Source locator	## Commercial and marketplace products → MercyCare Health Plans

UHC Medicare Advantage

Record	Payer and scope	Status
r-6f9e888e1b	UnitedHealthcare · Medicare Advantage · National / plan specific	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current entry: MA medical-policy index includes rehabilitation therapy.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current entry: MA medical-policy index includes rehabilitation therapy.
Next verification	Separate MA rules from UHC commercial; check product PA and new-code adoption if applicable.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	MA medical-policy index
Source locator	## Medicare, federal programs, and self-funded plans → UHC Medicare Advantage

Cigna Medicare

Record	Payer and scope	Status
r-c744b8d13b	Cigna · Medicare Advantage · National / plan specific	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current entry: Cigna policy index is a commercial coverage position, not proof of Medicare applicability.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current entry: Cigna policy index is a commercial coverage position, not proof of Medicare applicability.
Next verification	Obtain exact MA plan/provider rules before extrapolating AAC or speech criteria.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	Cigna policy index
Source locator	## Medicare, federal programs, and self-funded plans → Cigna Medicare

Humana Medicare Advantage

Record	Payer and scope	Status
r-9285fe6382	Humana · Medicare Advantage · National / plan specific	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current entry: medical coverage policies and PA lookup.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current entry: medical coverage policies and PA lookup.
Next verification	Check member plan and 2027 code, rate and therapy authorization treatment; pediatric volume may be limited.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	medical coverage policies · PA lookup
Source locator	## Medicare, federal programs, and self-funded plans → Humana Medicare Advantage

NGS Medicare Part B

Record	Payer and scope	Status
r-f9ec572e87	NGS Medicare · Medicare Part B · National / plan specific	Code/rate/crosswalk verification open

Field	Evidence
Summary	Verified correction: Illinois is Jurisdiction 6, not Jurisdiction K (CMS J6 contractor listing).
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Verified correction: Illinois is Jurisdiction 6, not Jurisdiction K (CMS J6 contractor listing).
Next verification	Watch CMS final 2027 fee schedule and J6 instructions; Medicare is a benchmark, not a pediatric commercial rate.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	CMS J6 contractor listing
Source locator	## Medicare, federal programs, and self-funded plans → NGS Medicare Part B

TRICARE West · TriWest

Record	Payer and scope	Status
r-aa15048000	TRICARE · Military health · National / plan specific	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current coverage/route: TRICARE speech therapy, updated Oct 1, 2026; TriWest referrals and authorizations.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current coverage/route: TRICARE speech therapy, updated Oct 1, 2026; TriWest referrals and authorizations.
Next verification	Confirm referral/authorization and new-code handling for Illinois military families.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	TRICARE speech therapy · TriWest referrals and authorizations
Source locator	## Medicare, federal programs, and self-funded plans → TRICARE West · TriWest

VA CCN Region 2 · Optum

Record	Payer and scope	Status
r-01bdd160eb	VA CCN · VA community care · National / plan specific	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current route: VA says Illinois is Region 2 and claims follow authorization/TPA.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current route: VA says Illinois is Region 2 and claims follow authorization/TPA.
Next verification	Low pediatric priority; keep separate from TRICARE and verify VA referral and coding if a case arises.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	VA says Illinois is Region 2 · claims follow authorization/TPA
Source locator	## Medicare, federal programs, and self-funded plans → VA CCN Region 2 · Optum

FEHB · BCBS FEP

Record	Payer and scope	Status
r-c0ba09e7c0	BCBSIL · Commercial / plan specific · IL	Code/rate/crosswalk verification open

Field	Evidence
Summary	Current benefit reference: 2026 FEP Blue Focus brochure has its own therapy benefits and visit limits.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	Current benefit reference: 2026 FEP Blue Focus brochure has its own therapy benefits and visit limits.
Next verification	Identify Standard, Basic or Focus and plan year; obtain 2027 brochure and code rules. Do not assume BCBSIL commercial terms.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	2026 FEP Blue Focus brochure
Source locator	## Medicare, federal programs, and self-funded plans → FEHB · BCBS FEP

UMR

Record	Payer and scope	Status
r-1a97b39f75	UMR · Employer plan / TPA · National / plan specific	Code/rate/crosswalk verification open

Field	Evidence
Summary	TPA: UHC identifies UMR as self-funded administrator; UMR PA tool varies by group plan.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	TPA: UHC identifies UMR as self-funded administrator; UMR PA tool varies by group plan.
Next verification	Get employer plan document and member-specific PA/coding answer; UHC commercial rules may not govern.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	UHC identifies UMR as self-funded administrator · UMR PA tool
Source locator	## Medicare, federal programs, and self-funded plans → UMR

Allied Benefit Systems

Record	Payer and scope	Status
r-70f0af140a	Allied Benefit Systems · Employer plan / TPA · National / plan specific	Code/rate/crosswalk verification open

Field	Evidence
Summary	TPA: provider resources and network explanation describe self-insured group variation.
Services	SLP
Last checked	2026-10-09
Dates	No verified event date
Verified reference	TPA: provider resources and network explanation describe self-insured group variation.
Next verification	Identify employer, network and plan document before drawing a therapy coverage or 2027 crosswalk conclusion.
2027 code adoption	Not verified by product
New-code allowance	Not verified by product
Authorization crosswalk	Not verified by product
Timed units / add-ons	Not verified by product
Same-day edits	Not verified by product
Applicability	SLP watch; other services require separate verification
Source	provider resources · network explanation
Source locator	## Medicare, federal programs, and self-funded plans → Allied Benefit Systems

SLP

Record	Payer and scope	Status
r-dad083e44d	Shared billing reference · Commercial / plan specific · National / plan specific	Apply exact payer/product rule

Field	Evidence
Summary	Speech-code adoption, timed base/add-on documentation, voice/fluency/language service distinctions, cognitive/swallowing/AAC policy and prior-approval conversion.
Services	SLP
Last checked	2026-10-08
Dates	No verified event date
Question or rule	Speech-code adoption, timed base/add-on documentation, voice/fluency/language service distinctions, cognitive/swallowing/AAC policy and prior-approval conversion.
Source	Source needed
Source locator	## Questions by service → SLP

Audiology

Record	Payer and scope	Status
r-09f8a6f70e	Shared billing reference · Commercial / plan specific · National / plan specific	Apply exact payer/product rule

Field	Evidence
Summary	Hearing-test/rehabilitation codes, hearing-aid benefit, device versus professional-service reimbursement, diagnosis and same-day testing edits.
Services	Audiology
Last checked	2026-10-08
Dates	No verified event date
Question or rule	Hearing-test/rehabilitation codes, hearing-aid benefit, device versus professional-service reimbursement, diagnosis and same-day testing edits.
Source	Source needed
Source locator	## Questions by service → Audiology

Rates / crosswalks

Record	Payer and scope	Status
r-77c790ece2	Shared billing reference · Commercial / plan specific · National / plan specific	Apply exact payer/product rule

Field	Evidence
Summary	Written code-specific allowance and authorization conversion needed by product. Generic adoption notices do not provide either.
Services	SLP, Audiology
Last checked	2026-10-08
Dates	No verified event date
Question or rule	Written code-specific allowance and authorization conversion needed by product. Generic adoption notices do not provide either.
Source	Source needed
Source locator	## Verified billing rules and gaps → Rates / crosswalks

Diagnosis / same day

Record	Payer and scope	Status
r-d56611a178	Shared billing reference · Commercial / plan specific · National / plan specific	Apply exact payer/product rule

Field	Evidence
Summary	Capture exact diagnosis, benefit category, procedure pair, provider/discipline, setting, modifiers, edit version and denial/remittance.
Services	SLP, Audiology
Last checked	2026-10-08
Dates	No verified event date
Question or rule	Capture exact diagnosis, benefit category, procedure pair, provider/discipline, setting, modifiers, edit version and denial/remittance.
Source	Source needed
Source locator	## Verified billing rules and gaps → Diagnosis / same day

Pediatric Medicaid

Record	Payer and scope	Status
r-4061373642	Shared billing reference · Commercial / plan specific · National / plan specific	Apply exact payer/product rule

Field	Evidence
Summary	Reconcile HFS notices/EPSDT, exact MCO clinical criteria and actual claim/authorization configuration.
Services	SLP, Audiology
Last checked	2026-10-08
Dates	No verified event date
Question or rule	Reconcile HFS notices/EPSDT, exact MCO clinical criteria and actual claim/authorization configuration.
Source	Source needed
Source locator	## Verified billing rules and gaps → Pediatric Medicaid

ASHA transition resources announced October 9 2026

Published October 9, 2026 · checked October 13 · national professional guidance. ASHA announced refreshed resources following AMA’s release of the 2027 code book: a coding readiness checklist, treatment coding quick guide, payer code-use tracker, template payer letter and code-by-code videos.

Practical use: Map services and direct treatment time to the correct base/add-on pair, review documentation and billing-system configuration, and record each payer’s acceptance date, authorization requirements, billing expectations and payment rates separately. ASHA’s resources do not establish a payer’s adoption or contracted allowance. Medicare final values remain dependent on the final 2027 payment rule.

ASHA October 9 announcement — Transition resources · Current implementation resources and downloads