Illinois-first policy reference from SLPoutLOUD Advocacy. The original toolkit roster has 23 targets mapped into 28 product and program rows. Optum Physical Health and Optum Medicare delegated therapy expand the searchable directory to 30 entries. Open a row for full policy libraries, specific SLP documents and authorization sources. Original policy baselines retain their October 10 dates; policy-source locations were checked October 13, 2026.

Search the payor map

Filter by payer, product lane, evidence signal or topic. Search also finds policy titles and source notes, including Optum. Ten rows appear per page; expand a row for the full policy links, document versions, notice dates and unresolved questions. Counts describe the source inventory, not payer readiness. Source locations checked October 13, 2026.

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

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.

Full plan policy libraries

Every entry in the original 28-row roster now has a policy-library, document or unresolved-source route below. Two Optum delegated-review entries expand the searchable map to 30. These are SLP and audiology policy sources, authorization tools and payment references; member contracts and benefits remain separate. Source locations checked October 13, 2026. Library located does not mean every policy in that library was audited or that 2027 code conversion is confirmed.

Commercial and Marketplace

Plan or program	Policies and official source routes	Scope and remaining gap
MT-01 BCBSIL commercial	Active and pending medical policies · Commercial authorization requirements	Repository located; disclaimer/search interface; Exact member product required November 2 source status: Attempted November 2, 2026: medical policy library returned a disclaimer; the policy index was not reviewed. Prior source-check date remains unchanged. November 3 source status: October 20 reimbursement notice and RP040 document checked November 3, 2026. RP040 effective December 31, 2026. Notice and document do not establish speech-specific applicability; consult exact product.
MT-02 UnitedHealthcare commercial	Habilitation and rehabilitation medical policy · Speech therapy reimbursement 2026R0097A · Full reimbursement policy library	Verify live PDF version; Document read; Includes add-on, replacement-code and same-day policies Index checked October 31, 2026: UHC lists the commercial/Individual Exchange speech therapy policy as last published March 10, 2026. This was an index check, not a comparison of the policy document; confirm contract and product applicability.
MT-03 Aetna commercial	Speech Therapy CPB 0243 · Aural Rehabilitation CPB 0034 · Melodic Intonation CPB 0284 · Speech Generating Devices CPB 0437 · Dysphagia CPB 0625 · Voice CPB 0646 · Auditory Processing CPB 0668	Policy/source location checked; product-specific adoption unresolved CPB 0243 checked October 31, 2026: Aetna lists last review May 13, 2026, original effective date May 21, 1998, and next review March 11, 2027. Prior policy text was not compared; product-specific coverage and 2027 implementation remain unresolved.
MT-04 Cigna commercial	Full current Cigna policy index · Speech Generating Devices 0049 · Speech Therapy 0177 retained PDF	Commercial scope; no Speech Therapy 0177 entry found in this index; Device policy, not treatment approval; Historical candidate: retrieved header effective 04/15/2024, next review 04/15/2025; current applicability unresolved November 2 source status: Attempted November 2, 2026: the policy index returned no readable content and the linked speech therapy PDF returned a 404. Prior successful dates remain unchanged; current policy and product applicability remain unresolved.
MT-05 Molina Illinois marketplace	2026 Illinois Marketplace manual V4 · Marketplace benefit interpretation policies · Clinical policy library · Billing and reimbursement policy library	Current provider-site link retrieved; Choose Illinois benefit interpretation November 2 source status: Attempted November 2, 2026: the linked benefit interpretation library returned a 404. Prior successful date remains unchanged; verify the Illinois Marketplace library and plan before relying on this link.
MT-06 Ambetter of Illinois	Illinois clinical and payment policies	CP.MP.49 PT/OT/SLP and CP.MP.188 pediatric oral function are listed; CP.MP.49 PDF fetch failed November 2 source status: Index checked November 2, 2026: the Illinois Ambetter policy library lists therapy policy CP.MP.49. Its linked PDF returned 403, so its text, version and applicable plan rules were not checked or compared.
MT-07 Oscar Illinois	Oscar medical guidelines library · Home Care SLP CG023 v12 · Code-specific authorization list	Home Care SLP CG023 v12 listed; outpatient-specific criteria still needed; Document link located; PDF fetch failed. Home-care scope only; Member/product rule needs confirmation November 2 source status: Index checked November 2, 2026: Oscar lists home-care SLP guideline CG023 version 12. Its linked PDF could not be retrieved; document content and outpatient applicability remain unverified.
MT-08 Health Alliance / Carle	Discontinuation and runout FAQs · Legacy clinical policy portal	Official indexed notice dated 09/30/2025; full page fetch failed; Unavailable in this check; historical coverage/claim matters only November 2 source status: Attempted November 2, 2026: the linked discontinuation FAQ returned a 502. Earlier source-check dates remain unchanged. November 3 source status: Clinical policy portal attempted November 3, 2026 and returned 502. Prior successful check date unchanged; current applicability remains unresolved.
MT-09 MercyCare Illinois	MercyCare medical policy library	Repository read; specific outpatient SLP criteria not located November 2 source status: Index checked November 2, 2026: the retrieved medical policy page did not show a speech-specific match. This index check does not establish coverage or review the full policy library.
MT-29 Optum Physical Health delegated plans	Full Optum Physical Health clinical policy library · Full Optum reimbursement policy library · Speech Language Pathology 491 retained PDF · Timed Therapeutic Interventions 0048 · Documentation for Timed Procedures 0049 · Mutually Exclusive Procedures 0059 · Modifiers GN GO GP CQ and CO 0061 · Multiple Therapy Procedure Reduction 0068 · Telehealth Reimbursement 0070 · Operations Manual · Clinical submission forms	Approval 04/27/2023; next review 04/2024. Not listed in retrieved current clinical index; current applicability unconfirmed; Approval 04/2026; no 926xx match found; not a verified 2027 SLP timing rule; Approval 04/2026; verify covered code scope; Approval 04/2026; Approval 04/2026; Approval 04/2026; applies per listed code and contract; Approval 04/2026; Verify applicable product and edition; Forms located; exact member/program workflow must be verified

Illinois Medicaid and Early Intervention

Plan or program	Policies and official source routes	Scope and remaining gap
MT-10 HFS Medicaid FFS	Therapy Services Handbook J200 · Therapy fee schedule · HFS provider notices	Latest displayed effective schedule 12/01/2024; not evidence of 2027 rates; Reconcile handbook with later applicable notices
MT-11 BCCHP Medicaid	BCBSIL authorization instructions · BCCHP PA code list retained version · Carelon rehabilitation resources and BCCHP code list · Carelon current rehabilitation guidelines	Indexed 92507/92508 Carelon routes; confirm latest version before use; BCCHP-specific list available; Clinical criteria do not establish plan benefits
MT-12 Aetna Better Health Illinois	Illinois clinical and payment policies · Illinois PA and ProPAT tools	Current Medicaid PA requirement grid linked; no 2027 conversion established Source check: Illinois Medicaid clinical and payment policy landing page checked November 1, 2026; it notes delegated guidelines may apply. This was a landing-page check, not a comparison of all policy documents. Product-specific authorization and 2027 code handling remain unresolved. November 3 source status: Illinois clinical/payment policy landing page checked November 3, 2026; individual policies and payer code adoption not compared.
MT-13 Meridian Medicaid	PT OT and Speech Therapy CP.MP.49 · Full Medicaid clinical and payment library · Service authorization and therapy delegate	Last revision 06/2025; plan effective date must be confirmed; Evolent therapy route listed Source check: Illinois Medicaid clinical index and CP.MP.49 checked November 1, 2026. The linked policy states last revision June 2025 and addresses outpatient or home therapy authorization; prior version not compared. Applicable plan, clinical decision criteria, and 2027 handling remain unresolved.
MT-14 YouthCare Medicaid	YouthCare clinical and payment library · YouthCare service authorization	Repository read; no separately identified SLP document in retrieved index; Evolent therapy route listed; separate product from Meridian Source check: Illinois YouthCare clinical index and authorization page checked November 1, 2026. No speech-specific entry was identified in the retrieved index; this does not establish absence of coverage. Plan and code-specific requirements remain unresolved.
MT-15 Molina Illinois Medicaid	2026 Illinois Medicaid manual V3 · Illinois-specific clinical policies · Enterprise clinical policy library · Illinois provider and authorization resources	Header last updated 10/2026 Source check: Illinois Molina clinical policy index checked November 1, 2026; no speech-specific match was identified on the retrieved Illinois page. Enterprise policies and individual documents were not compared; coverage and authorization remain product-specific.
MT-16 CountyCare Medicaid	CountyCare clinical criteria · CountyCare authorization route	Public general clinical criteria; outpatient SLP-specific document not identified; Member, code and delegate verification needed Source check: CountyCare Illinois Medicaid clinical criteria and provider-notices pages checked November 1, 2026. The clinical index did not identify a speech-specific document; this is not a coverage determination. Individual notices and plan-specific authorization remain to be reviewed.
MT-17 HFS school-based services	Local Education Agencies handbook · School Based and Linked Health Center fee schedule · HFS handbook directory	School Medicaid billing lane; Separate school-clinic program; do not substitute for LEA/IEP billing instructions
MT-18 Illinois EI / CBO	IDEC FY2027 EI provider rate notice	Published 07/01/2026; effective 10/01/2026. EI/CBO rules separate from outpatient Medicaid

Medicare and federal programs

Plan or program	Policies and official source routes	Scope and remaining gap
MT-19 UHC Medicare Advantage	UHC MA rehabilitation medical policy · Full Medicare Advantage policy library · Optum Medicare outpatient skilled therapy 497	Includes outpatient rehabilitation; verify exact MA product; Effective 02/11/2026; only when applicable to delegated review November 3 source status: Indexes and MMP079.20 reviewed November 3, 2026. Policy approved October 14; effective November 1. Its revision history labels 92507, 92508 and 92526 deleted September 30, conflicting with ASHA guidance for 92507 and 92508. Previous version not retrieved; impact and claims handling unresolved. Verify plan and delegated review.
MT-20 HealthSpring Medicare Advantage (formerly Cigna Medicare)	HealthSpring medical policies · HealthSpring clinical review framework	Current MA source lane; separate from Cigna commercial; Specific SLP policy not identified in current public list November 3 source status: Medical policy index checked November 3, 2026. Speech-generating devices policy listed effective July 21, 2026; document not compared. Exact MA product, SLP therapy criteria and authorizations remain unresolved.
MT-21 Humana MA / FIDE SNP	Humana medical and pharmacy coverage search · Humana prior authorization instructions	Select Medicare and exact product; state Medicaid policies do not establish MA coverage; Specific speech code and plan lookup required November 3 source status: Coverage search landing page checked November 3, 2026; searchable results and individual policies not reviewed. Exact MA/FIDE product and speech requirements remain unresolved.
MT-22 NGS Medicare Part B	CMS Medicare Benefit Policy Manual Chapter 15 · CMS Illinois MAC Jurisdiction 6	Outpatient therapy section 220 and SLP section 230.3; Confirm applicable NGS LCD/article by service, state and date
MT-23 TRICARE regional plans	TRICARE speech therapy benefit · TRICARE East contractor · TriWest West provider resources	Referral/prescription requirement published; Humana Military; West route retained; choose correct beneficiary region November 3 source status: Speech therapy benefit page checked November 3, 2026; source last updated October 1, 2026. Contractor notices and prior versions not compared. Confirm region, plan and authorization.
MT-24 VA CCN Region 2 / Optum	VA Community Care Network policy and regions · Optum VA CCN resource and portal route	Referral and claims portal; separate from commercial Optum policies
MT-25 FEHB / BCBS FEP	FEP full FEHB and PSHB brochure library · FEHB Standard and Basic 2026 brochure · FEHB Focus 2026 brochure	Select correct option and program
MT-30 Optum Medicare delegated skilled therapy	Full Optum Physical Health clinical policy library · Medicare Outpatient Skilled Therapy 497 · Operations Manual · Clinical submission forms	Effective 02/11/2026; Medicare scope; Verify applicable product and edition; Forms located; exact member/program workflow must be verified

Employer plans and coordination

Plan or program	Policies and official source routes	Scope and remaining gap
MT-26 UMR	UMR full medical policy library · UMR member-specific authorization tool	Employer plan may differ; determine applicable adopted criteria; Secure portal required for member-specific requirements Index checked November 2, 2026: UMR’s medical-policy index lists outpatient habilitation and rehabilitation therapy for commercial and individual exchange, last published and effective July 1, 2026. This is an index check; the full document and prior version were not compared. Employer plan adoption, coverage and terms require confirmation.
MT-27 Allied Benefit Systems	Allied provider documents · Allied network identification	Public forms repository; not a universal SLP benefit policy; Obtain employer SPD and identified network/delegate policy
MT-28 IAMHP	IAMHP provider resources	Coordination association, not a plan policy or coverage authority

Optum document versions

Optum policy or resource	Version and applicability
Full Optum Physical Health clinical policy library	Public policy library; select the exact client plan and product.
Full Optum reimbursement policy library	Public policy library; select the exact client plan and product.
Medicare Outpatient Skilled Therapy 497	Effective 02/11/2026; Medicare scope
Speech Language Pathology 491 retained PDF	Approval 04/27/2023; next review 04/2024. Not listed in retrieved current clinical index; current applicability unconfirmed
Timed Therapeutic Interventions 0048	Approval 04/2026; no 926xx match found; not a verified 2027 SLP timing rule
Documentation for Timed Procedures 0049	Approval 04/2026; verify covered code scope
Mutually Exclusive Procedures 0059	Approval 04/2026
Modifiers GN GO GP CQ and CO 0061	Approval 04/2026
Multiple Therapy Procedure Reduction 0068	Approval 04/2026; applies per listed code and contract
Telehealth Reimbursement 0070	Approval 04/2026
Operations Manual	Verify applicable product and edition
Clinical submission forms	Forms located; exact member/program workflow must be verified

Optum scope: Physical Health delegated utilization review, Medicare skilled therapy and VA Community Care are separate lanes. VA referral/claims rules come from the VA CCN route. The retained 491 SLP PDF has 2023 approval and 2024 review dates and was not listed in the current retrieved Optum clinical index. Ask Optum which criteria are currently applied to the exact client plan; do not treat that PDF as a universal current exclusion.

Native source and next-question tables

Illinois Medicaid school and Early Intervention

ID and product	Evidence signal and next question	Date of notice	Effective or review date and official source
MT-10 · HFS Medicaid FFS	🟦 Published change. Sept 23 notice confirms habilitative early-acquired SLP coverage under 21, including stuttering, DOS Jul 1 Next: Check J-200 revision, therapy fees and 2027 code set	Sep 23, 2026	Jul 1, 2026 effective · HFS stuttering notice
MT-11 · BCCHP Medicaid	🟦 Published change. Medicaid ID replaces subscriber ID in eligibility/claim status Nov 16 and all transactions Jan 1 Next: Test RIN fields and Carelon therapy authorization units	Sep 25, 2026	Nov 16, 2026; Jan 1, 2027 · BCCHP ID notice
MT-12 · Aetna Better Health Illinois	🟩 Current policy. Illinois clinical/payment policy portal; HFS pediatric stuttering notice applies to MCOs Next: Confirm therapy PA/units and payer implementation separately from commercial Aetna	Not found in checked sources	Unknown · IL clinical/payment policies
MT-13 · Meridian Medicaid	🟩 Current policy. Clinical/payment index lists PT/OT/SLP CP.MP.49 Next: Check Evolent/plan PA code list and 2027 authorization conversion	Jan 1, 2026 (UM website notice)	Unknown · Meridian clinical policies
MT-14 · YouthCare Medicaid	🟩 Current policy. YouthCare has distinct policy and therapy authorization route Next: Verify foster-youth product PA and units apart from Meridian	Not found in checked sources	Unknown · YouthCare service authorization
MT-15 · Molina Illinois Medicaid	Current Illinois Medicaid manual V3 header updated October 2026; repaired superseded manual URL. Next: Check therapy PA lookup, HFS stuttering implementation and 2027 codes	Not found in checked sources	10/2026 manual update · 2026 Illinois Medicaid manual V3
MT-16 · CountyCare Medicaid	🟩 Current policy. Cook County PA criteria and outpatient therapy delegate Next: Confirm therapy delegate, approved units and 2027 conversion for an enrolled member	Sep 30, 2025 (PA tool notice)	Unknown · CountyCare PA criteria
MT-17 · HFS school-based services	🟩 Current policy. School-based fee schedule effective Apr 1, updated Jul 21, 2026 Next: Get school-specific code/unit instructions; do not apply clinic rules to IEP billing	Not found in checked sources	Jul 21, 2026 update · School-based fee schedule
MT-18 · Illinois EI / CBO	🟦 Published change. IDEC FY2027 EI rate schedule effective Oct 1; SLP 92507 remains listed in 15-minute units Next: Check CBO treatment-code transition and EI authorization/rate crosswalk separately	Jul 1, 2026	Oct 1, 2026 effective · IDEC FY2027 notice pp. 6–7

Commercial and marketplace

ID and product	Evidence signal and next question	Date of notice	Effective or review date and official source
MT-01 · BCBSIL commercial	🟦 Published change. Sept 15 notice: annual CPT/HCPCS updates; deleted codes rejected Jan 1, 2027 Next: Request code-specific PPO/Blue Choice allowances and PA conversion	Sep 15, 2026	Jan 1, 2027 · Code and fee notice
MT-02 · UnitedHealthcare commercial	🟩 Current policy. Speech reimbursement and habilitation policies are published; 2027 speech implementation unresolved Next: Check timed units, same-day edits, contracted allowances and PA	Oct 1, 2026 (general bulletin)	Unknown · Commercial reimbursement index
MT-03 · Aetna commercial	🟩 Current policy. Speech Therapy CPB 0243; separate AAC and dysphagia bulletins Next: Check benefit terms, diagnoses, AAC/feeding coverage and new code fees	October 2026 (month only)	Mar 11, 2027 review · Speech Therapy CPB 0243
MT-04 · Cigna commercial	🟩 Current policy. Speech Generating Devices policy 0049 effective Jan 15, 2026; separate treatment policy needed Next: Separate device and therapy benefits; obtain 2027 coding rule	Not found in checked sources	Jan 15, 2027 review · SGD 0049
MT-05 · Molina Illinois marketplace	🟩 Source recorded. Marketplace provider resources and Availity authorization route; distinct from Medicaid Next: Check ACA product network, PA and 2027 code allowances	Not found in checked sources	Unknown · Illinois marketplace providers
MT-06 · Ambetter of Illinois	🟩 Current policy. Illinois clinical/payment index lists PT/OT/SLP policy CP.MP.49 Next: Check marketplace PA and 2027 new-code rates	Not found in checked sources	Unknown · Illinois clinical/payment policies
MT-07 · Oscar Illinois	🟩 Source recorded. Provider prior-authorization list is code/member specific; Illinois plan listings exist Next: Verify therapy and telehealth PA for exact plan	October 2026 (month only)	Unknown · Provider PA list
MT-08 · Health Alliance / Carle	Legacy/runout source; indexed discontinuation notice says commercial and MA business ended after 2025. Full notice and policy portal could not be fetched. Next: Use only for historical claims/contracts; identify the successor member plan.	Unverified: source unavailable	Jan 1, 2026 contract termination (indexed) · Discontinuation FAQs (official indexed source)
MT-09 · MercyCare Illinois	🟩 Source recorded. Medical policies say coverage follows member plan; Illinois large-group product includes speech Next: Confirm Illinois group benefit, visit cap and authorization	Not found in checked sources	Unknown · MercyCare medical policies

Medicare and federal programs

ID and product	Evidence signal and next question	Date of notice	Effective or review date and official source
MT-19 · UHC Medicare Advantage	🟩 Current policy. MA rehabilitation therapy medical-policy index is separate from UHC commercial Next: Check actual MA product PA, units and 2027 code adoption	Oct 1, 2026 (general bulletin)	Unknown · UHC MA policy index
MT-20 · HealthSpring Medicare Advantage (formerly Cigna Medicare)	HealthSpring current medical policy library and clinical review framework located; Cigna commercial criteria are not substituted. Next: Request exact MA product therapy criteria, authorization rules and 2027 conversion.	Not found in checked sources	Unknown · HealthSpring medical policy library
MT-21 · Humana MA / FIDE SNP	🟨 Classification correction. HFS ended MMAI Dec 31, 2025 and transitioned to D-SNPs Jan 1, 2026; toolkit's MMAI label is stale Next: Identify current MA/FIDE product and check referral, therapy PA and 2027 code rules	Not found in checked sources	Jan 1, 2026 transition · HFS MMAI end date
MT-22 · NGS Medicare Part B	🟨 Classification correction. CMS lists Illinois under MAC Jurisdiction 6; toolkit says Jurisdiction K Next: Watch final 2027 MPFS and J6 coding instructions; benchmark only	Not found in checked sources	Unknown · CMS J6 contractor
MT-23 · TRICARE regional plans	Speech therapy benefit and East/West contractor routes located; choose the beneficiary's actual region. Next: Confirm Prime/Select, beneficiary region and referral/authorization. Do not assume TriWest is the applicable contractor.	Not found in checked sources	Unknown · TRICARE speech therapy
MT-24 · VA CCN Region 2 / Optum	🟩 Current policy. VA lists Illinois in Region 2; community care needs VA referral/authorization Next: Keep separate from TRICARE; verify only for an applicable referral	Sep 9, 2026 (general bulletin)	Unknown · VA CCN regions
MT-25 · FEHB / BCBS FEP	🟩 Current policy. FEP Blue Focus 2026 brochure has distinct speech/OT/PT visit benefit; other FEP options differ Next: Identify Standard, Basic or Focus and current plan year; no BCBSIL commercial extrapolation	Not found in checked sources	2027 brochure pending · 2026 FEP Blue Focus brochure

Employer plans and coordination

ID and product	Evidence signal and next question	Date of notice	Effective or review date and official source
MT-26 · UMR	🟩 Current policy. Third-party administrator; PA tool and employer-plan terms govern Next: Get employer SPD, network and member-specific PA/coding response	Oct 1, 2026 (general bulletin)	Unknown · UMR PA tool
MT-27 · Allied Benefit Systems	🟩 Current policy. Third-party administrator of self-insured employer plans; plan documents vary Next: Identify employer plan, PPO network and authorization delegate	Not found in checked sources	Unknown · Allied provider resources
MT-28 · IAMHP	⬜ Coordination. Illinois Medicaid MCO trade association, not a claims payer Next: Use for cross-plan advocacy; obtain billing rules from each MCO	Not found in checked sources	Unknown · IAMHP provider resources

Interpretation and verification backlog

Published change is a dated rule or operational notice. Current policy/source recorded identifies an existing official policy or entry point, not proof of 2027 adoption. Verify product means the linked policy has a different scope. Unknown dates are left unknown; Aetna’s next review date is not a comment deadline.

For each active product, close these fields separately: 2027 code adoption; base and add-on time rules; 92507 handling; existing authorization conversion; diagnosis and habilitation coverage; AAC device versus treatment; feeding and swallowing; telehealth; same-day edits; GN/modifiers; fee allowance; actual paid claim. Secure contracts and member benefits can differ from public policy.

Roster corrections: Illinois Medicare is NGS Jurisdiction 6, not K (CMS). The toolkit’s Humana “MMAI” label is historical: Illinois ended MMAI December 31, 2025 and moved to D-SNPs January 1, 2026. EI/CBO, HFS school services and IAMHP are programs/association, not conventional insurers. No contacts from the toolkit were treated as verified.

Coverage checkpoint: 30 product, program and delegated-review entries: the original 28 roster rows plus Optum Physical Health and Optum Medicare skilled therapy. Policy libraries or unresolved retrieval routes are recorded for every roster entry. Specific SLP criteria remain unresolved for Cigna commercial, YouthCare, CountyCare, MercyCare and HealthSpring; secure employer-plan terms and 2027 rate/authorization conversions remain separate verification work. Health Alliance is retained as legacy/runout.

Notice publication and disclosure sources

Notice sources checked October 13, 2026 across all 28 product and program rows: 10 exact notice or general-bulletin dates, 2 month-only newsletter entries, and 16 rows without a verified publication date. General bulletins and authorization-tool notices are labeled by topic; they do not establish a speech-policy revision or 2027 code adoption. The policy baseline above remains October 10, 2026.

Expand a payer-map row for the dated notice or newsletter link, source-check status and limitations. “Not found in checked sources” means this review did not establish a publication date; it does not mean the payer issued no notice. Review, update, effective, plan-year and website copyright dates are not substituted for publication dates.

Required public information and legal verification

Authority or official route	Public information to look for	Scope and verification
CMS prior authorization reporting guidance	Public annual non-drug PA metrics and list of services requiring PA, beginning in 2026	Verified CMS guidance. Applies to MA, Medicaid/CHIP programs and managed care, and QHP issuers on federally facilitated exchanges. This is not a notice requirement for every rate or coding change; do not automatically apply the FFE category to Illinois marketplace products.
Medicare Advantage coverage criteria at 42 CFR 422.101	Public internal coverage criteria, supporting evidence, sources and rationale where Medicare criteria are not fully established	Current eCFR text read, subsection (b)(6). Applies to MA internal coverage criteria, not a universal reimbursement-change bulletin requirement.
Illinois PA disclosure authority 215 ILCS 200/20 and Act scope	Candidate authority to verify for public PA service lists, Illinois posting dates and advance written change notices	Current legal-text verification pending. Official indexed text identifies these requirements, but full official pages and the legal connector failed to load. Verify current wording, product exclusions and notice timing before using this as a compliance finding.
Illinois JCAR rulemaking summary for 89 Ill Admin Code 140.76	Candidate Illinois Medicaid MCO source for public utilization-review policies and advance website/provider notifications	Current rule and scope verification pending. Rule title and hospital provisions require careful applicability review. Meridian’s Jan 1, 2026 notice and CountyCare’s Sep 30, 2025 notice identify website changes tied to this rule; payer statements do not replace current legal text.

Regulatory boards and filing repositories

Source	What to monitor	Tracking limit
Illinois HFS provider notices	State Medicaid coverage, billing, fees and operational notices	Record the notice’s printed date and applicable programs; an HFS notice is not an insurer-authored notice.
IDOI Company Bulletins	Regulatory guidance addressed to insurers	IDOI says bulletins are not updated as regulations change and should not be relied on as the primary current legal source.
IDOI rate rule and form public access	SERFF filings and older policy-form filings	A filing date is not automatically a provider-notice publication date or a contracted reimbursement rate.
Illinois Register	Proposed and adopted state rules and rulemaking dates	Entry point identified; page unavailable in this check. Keep proposal, adoption and effective dates separate.

Next verification: retrieve current Illinois PA disclosure law and 140.76 text, then match each applicable product’s PA list and dated change history. Public notice publication does not establish delivery to a contracted provider.

External payer updates checked October 13 2026

Premera speech treatment transition

Published October 1, 2026 · announced future change January 1, 2027 · Washington provider notice · checked October 13. Premera announces replacement of 92507 with ten timed treatment codes across five service categories. It directs providers to document direct one-to-one care time, avoid counting the same time toward multiple services, and use the combined code when treating speech sound and language together. Rates and existing-authorization conversion are not specified.

Scope: This is a Premera comparison example, not BCBSIL or Illinois Medicaid implementation authority. The notice’s statement that AMA has not released the official code set is inconsistent with ASHA’s October 9 report following release of the 2027 code book; use current ASHA guidance for code numbers. Premera describes 92508 as remaining untimed; ASHA separately reports revised wording.

Next check: Obtain the exact member-product acceptance date, base/add-on approval handling and contracted allowances before configuring claims.

Premera notice — What’s Changing · ASHA October 9 announcement

BCBSIL January procedure code changes

Published September 15, 2026 · announced future change January 1, 2027 · checked October 13. BCBSIL states it will implement CPT/HCPCS additions, deletions and revisions and will not accept deleted codes for dates of service from January 1. This is a general code-set notice; it does not publish SLP-specific rates or establish transfer of existing 92507 approvals.

Next check: Request contracted allowances for the new base/add-on pairs through the fee schedule request route. Eligible PPO and Blue Choice PPO professional providers may use the Availity Fee Schedule Listing tool.

BCBSIL procedure code and fee schedule notice

Other payer findings from this scan

BCBSIL lists RP040 Physical Medicine and Rehabilitation Services as posted October 2 and effective December 31, 2026. The retrieved 12-page document covers physical medicine/rehabilitation billing; no speech or 92654 text was found. It is a review candidate, not evidence of adoption of the new SLP codes. Document header approval date: September 21, 2026.

BCBSIL pending policy index · RP040 PDF — header and reimbursement sections

Targeted public searches for UHC, Optum Physical Health, Meridian and Molina did not locate a new SLP 2027 implementation announcement in this scan. Their adoption, authorization conversion and rates remain product-specific questions; this does not establish that guidance is absent.