Speech Therapy Providers in California

Medi-Cal speech therapy and the physician referral

Medi-Cal covers medically necessary speech therapy only on the written referral of a physician or dentist, delivered by a qualified Medi-Cal provider. The referral lists the diagnosis, requested services, frequency and goals, and it is limited to six months. For members under 21, the Medi-Cal manual says additional services may be available under EPSDT when medically necessary, and services that maintain a child's condition can qualify. The manual sets a general outpatient limit of two services per month, so if your child needs more, ask the provider to request it under EPSDT.

• Ask your pediatrician or dentist for the written referral before you book an evaluation.
• Track the six-month referral date and request the next one early.
• Managed care members should ask their plan which speech providers are in network.

Habilitative coverage under Health and Safety Code 1367.005

Individual and small-group health plan contracts issued or renewed since 2017 must cover habilitative services. The statute defines them to include speech-language pathology and gives the example of a child who is not talking at the expected age. Habilitative services follow the same terms as rehabilitative services, and the two sets of limits cannot be combined. The benchmark plan summary CMS publishes lists speech therapy as covered with no visit limit stated, so ask your plan for its current limit, prior authorization rules and in-network list. Self-funded employer plans follow federal ERISA rules, not this statute.

Early Start speech and language services

Early Start serves infants and toddlers from birth to 36 months who have at least a 25 percent developmental delay in an area such as expressive or receptive language, or an established risk condition. Speech and language services are on its list of available services. Anyone can refer: call your Regional Center, your school district or the BabyLine at 800-515-2229. The Regional Center or district has 45 days to assign a service coordinator and complete evaluations. Evaluation, assessment and service coordination cost nothing, and insurance is used for medically necessary therapy such as speech.

School speech services under California Education Code

From age 3, children get special education through the local school district. A child qualifies as having a language or speech disorder when difficulty understanding or using language affects educational performance and a speech-language pathologist finds a speech sound, voice, fluency or language disorder, or a hearing-related disorder. Language and speech development and remediation is a designated instruction and service. After you request an evaluation, the district gives you a proposed assessment plan within 15 days. The IEP must follow within 60 days of your written consent.

Who licenses speech-language pathologists in California

State law bars anyone from practicing speech-language pathology or calling themselves an SLP without a license from the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board. A speech-language pathology assistant must be approved by the board and work under an SLP's supervision. School-employed SLPs can hold a Commission on Teacher Credentialing credential instead of a board license while working for a public school. California does not appear on the ASLP Interstate Compact map as a member state, so an SLP from another state still needs a California license.