From Medicare reimbursement to telehealth: how 2026 federal advocacy affects your practice and patients
On September 22-23, 2026, speech-language pathologists, audiology colleagues, and graduate students gathered in Washington for ASHA's annual Capitol Hill Day. The push centered on three access barriers: Medicare coding changes that affect reimbursement, telehealth rules that determine whether remote speech therapy remains available, and state scope-of-practice laws that can narrow or expand what SLPs may do. Clinicians who did not attend can still move the same priorities through ASHA's at-home advocacy tools, but the strongest influence still comes from a lawmaker hearing directly from a constituent who treats stroke, voice, and swallowing disorders.
A one-day email campaign lands in a lawmaker's inbox. A face-to-face meeting on Capitol Hill lands in the room where policy language is drafted. ASHA's 2026 Capitol Hill Day emphasized the face-to-face route, bringing audiologists, speech-language pathologists, assistants, and students to Washington, DC, on September 22-23.
ASHA described the event as its largest Hill Day of the year. A September 23 release reported more than 150 members on Capitol Hill meeting with members of Congress and their staffs.1 The delegation included clinicians, assistants, and SLP grad students, so the rooms held both experienced advocates and first-time participants learning how a congressional office functions. The event FAQ confirmed the September 22-23 dates but did not include a final attendance figure. Organizers have not yet published a state-by-state breakdown, so it is not possible to identify which states or districts were most represented. Likewise, no official count of House versus Senate meetings has been released for 2026.
The central message was patient access. Delegates brought a policy agenda tied to Medicare reimbursement stability, continued telehealth flexibility, and scope-of-practice protections for speech-language pathologists and audiologists. In staff briefings and member meetings, participants paired those priorities with evidence-based practice examples, such as how reimbursement uncertainty can limit service availability and how telehealth reaches patients who would otherwise miss care. Medicare reimbursement was not presented as a standalone issue; delegates connected it to the broader goal of preventing service denials and delays. The framing was practical: protect the services that allow patients to communicate, swallow, and participate in daily life.
No source tied to the 2026 event documents specific lawmaker commitments or public statements. That absence should not be read as failure; advocacy of this kind often produces follow-up over weeks and months rather than same-day pledges. For context, ASHA's 2025 Hill Day reported 301 participants, 262 congressional meetings, and representation from 49 states, but those are prior-year figures and cannot be applied to 2026. Until ASHA publishes final data, the clearest 2026 outcome is the volume of direct congressional contact: more than 150 advocates across multiple Capitol Hill offices on a single advocacy day.1 Students reading the 2026 advocacy scorecard should treat any unlabeled meeting totals as preliminary and monitor ASHA action alerts for legislator responses and co-sponsorship updates.
In fall 2026, three fronts control whether patients can actually get speech therapy: Medicare payment policy, telehealth authority, and state scope-of-practice rules. Each priority maps to a concrete access problem, from rural stroke survivors who cannot drive to a clinic to adults who need both swallowing and language treatment on the same day.
ASHA has long opposed the Multiple Procedure Payment Reduction, or MPPR, because it cuts reimbursement when a therapist provides more than one service to the same patient during a single visit. For an outpatient SLP, that can mean lower payment for cognitive therapy delivered alongside voice or swallowing treatment. The result is an access barrier: some practices stretch same-day services across multiple appointments or stop offering certain combinations, forcing patients to arrange extra travel or delay care.
The main repeal vehicle in 2026 is the RECOVER Act, H.R. 8386, introduced April 20 by Rep. Deborah Ross of North Carolina and referred to committee.1 As of late September 2026, no floor vote or committee markup has been reported. Therapy-focused organizations and their partners sent coalition letters to the Senate Finance Committee in March urging repeal23, but the outcome is still unresolved.
The Consolidated Appropriations Act of 2026, signed February 3, extended Medicare telehealth flexibilities through December 31, 20274, but the available record highlights physical and occupational therapy eligibility. SLP-specific permanent telehealth authority remains unsettled in the public documents reviewed for this section. Permanent authorization would let Medicare beneficiaries receive speech-language pathology services via telehealth without relying on short-term extensions. For patients who need remote swallowing, voice, or language therapy after a stroke or head and neck cancer, that uncertainty can interrupt access when temporary waivers lapse, especially in rural counties where an SLP is not nearby.
A specific Senate bill number such as S.6226 could not be verified with 2026 action in the sources available, so readers should treat any single telehealth bill claim cautiously. The practical takeaway is that telehealth remains a legislative priority, not a settled guarantee for speech services.
State rules add another layer to the SLP scope of practice. In some states, SLPA supervision rules require SLP assistants to be directly supervised in person, and cross-state telehealth can trigger telehealth licensure requirements for SLPs in the patient's state. Those requirements can reduce access in schools or rural facilities with limited supervisors. ASHA and state associations push for licensure compact language and updated supervision models, but progress is state by state. SLPs and students should track their own state's board because changes affect clinical placements, teletherapy jobs, and whether patients can continue care across state lines.
These proposed Medicare coding changes affect whether speech-language pathology services are recognized and reimbursed. The G-SLPP code and the new treatment code family are still proposed for calendar year 2027 as of September 2026, not finalized. Understanding the current proposal helps students and new clinicians see why coding accuracy matters for patient access and payment.
| Code | Description | Reimbursement/Status Notes |
|---|---|---|
| GSLPP | Individual treatment of speech, language, voice, communication, and/or auditory processing disorders for pediatric patients. CMS proposes valuing it using the work and direct practice expense values associated with CPT code 92507, assigning a work RVU of 1.30 based on 60 minutes of personally performed treatment. | Proposed in the CY 2027 Medicare Physician Fee Schedule rule. CMS proposes limiting reporting to one unit per patient per day, designating it as an always therapy service, and applying the multiple procedure payment reduction (MPPR). |
| New SLP treatment code family (10 codes replacing CPT 92507) | Beginning January 1, 2027, CPT code 92507 is scheduled to be replaced by a family of 10 speech-language pathology treatment codes describing individual treatment by clinical service with a time-based structure consisting of base and add-on codes. | CMS accepted ASHA's recommended work RVUs and direct practice expense inputs for all 10 new speech-language pathology treatment codes. CMS later published an updated table containing proposed values for all 10 codes. |
| CPT 92507 | Individual speech-language treatment service code that is proposed to be retired and replaced by 10 new CPT codes. | CMS released the proposed CY 2027 Medicare Physician Fee Schedule on July 14, 2026. The new speech-language pathology treatment codes are the subject of the proposed valuation and would replace CPT 92507. |
| Fluency-disorder treatment code | One of the new CPT code family categories covers treatment of fluency disorders. | CMS proposes the RUC-recommended values without modifications. The initial 30-minute codes are subject to MPPR, and additional 15-minute codes are not subject to MPPR. |
| Speech-sound-production-disorder treatment code | One of the new CPT code family categories covers treatment of speech sound production disorders. | CMS proposes the RUC-recommended values without modifications. The initial 30-minute codes are subject to MPPR, and additional 15-minute codes are not subject to MPPR. |
| Language-comprehension-and-expression-disorder treatment code | One of the new CPT code family categories covers treatment of language comprehension and expression disorders. | CMS proposes the RUC-recommended values without modifications. The initial 30-minute codes are subject to MPPR, and additional 15-minute codes are not subject to MPPR. |
| Combined speech-sound-production-and-language-disorder treatment code | One of the new CPT code family categories covers treatment of combined speech sound production and language disorders. | CMS proposes the RUC-recommended values without modifications. The initial 30-minute codes are subject to MPPR, and additional 15-minute codes are not subject to MPPR. |
| Voice-upper-airway-dysfunction-and-resonance-disorder treatment code | One of the new CPT code family categories covers treatment of voice, upper airway dysfunction, and resonance disorders. | CMS proposes the RUC-recommended values without modifications. The initial 30-minute codes are subject to MPPR, and additional 15-minute codes are not subject to MPPR. |
| New SLP base treatment codes | Base codes represent the initial 30 minutes of treatment in the new speech-language pathology code family. | CMS proposes designating the codes as always therapy services, requiring a therapy plan of care and therapy modifier regardless of whether physicians, nonphysician practitioners, or therapists furnish the service. Initial 30-minute codes are subject to MPPR. |
| New SLP add-on treatment codes | Add-on codes represent each additional 15 minutes of individual speech-language pathology treatment. | CMS proposes the RUC-recommended values without modifications. Additional 15-minute codes are not subject to MPPR. |
ASHA's national advocacy team does not work in isolation. The association coordinates closely with state speech-language-hearing associations to align federal and state policy efforts. ASHA typically provides model legislation, regulatory comments, talking points, and grassroots training, while state associations adapt those resources to local political realities and relationships.
Capitol Hill Day may be the most visible moment, but it sits inside a continuous advocacy calendar. ASHA's government affairs staff track federal bills year-round, arrange meetings between members and congressional offices, and issue action alerts when a vote or comment period is approaching. State associations keep their own legislative watchlists and often schedule state-level lobby days at different points in the year. The result is a layered system where a constituent email, a district meeting, or a statehouse visit can all reinforce the same federal priority.
State associations translate ASHA's national agenda into state-specific asks. For example, a federal push for telehealth flexibility may become a state bill requiring insurance parity for teletherapy. Medicare reimbursement concerns can shape state Medicaid rate campaigns. Scope of practice debates often move through state legislatures first, so state associations draft language, build coalitions with related provider groups, and prepare member testimony. This translation work keeps federal priorities grounded in the day-to-day realities of licensure, school caseloads, and local payment policies.
Students and clinical fellows are not just future advocates. Many state associations run student chapters or mentorship tracks that pair graduate students with experienced lobbyists and policy volunteers. Early-career SLPs often serve as district captains, help manage social media outreach, or organize campus advocacy events. Their direct connection to current SLP grad school curriculum and clinical placements gives them a fresh voice when explaining how proposed changes would affect new clinicians and the clients they serve.
Speech-language pathology advocacy no longer hinges on Capitol Hill alone; a clinician in any state can move a bill from a laptop.
ASHA's Take Action platform serves as the primary grassroots hub for audiologists and SLPs. After creating or logging into an ASHA account, you can browse federal and state campaigns, open a prewritten letter, and submit it directly to your elected officials. The platform also offers petitions when a campaign calls for them. In 2026, ASHA drafted two letters related to the Department of Education's "professional" degree classification issue and invited audiologists, SLPs, and students to sign one or both before ASHA submitted them. Because the letters are prewritten, a typical action takes only a few minutes, but you can add a sentence about your own caseload or community to strengthen the message.
For bill-specific outreach, start by identifying your U.S. Representative and two Senators. Most congressional websites include a contact form or district office phone number. ASHA encourages writing and calling, and it recommends personalizing messages with a local impact story. Briefly describe how a billing barrier, telehealth limit, or scope-of-practice restriction affects your patients. If you are unsure about a bill's status, ASHA's Advocacy News and Take Action alerts provide current summaries before you reach out.
State speech-language-hearing associations often organize district advocacy days, virtual meetings, and action alert email blasts tied to state legislation. For example, the Illinois Speech-Language-Hearing Association's ISHA Take Action page points members to ASHA's Take Action Center for national campaigns while using its own email blasts for state-level alerts. Joining a district-level event lets you meet a lawmaker or aide with a smaller group of colleagues, which can feel more approachable than a large Hill day. ASHA also encourages inviting elected officials to your workplace so they can see therapy in action.
A low-effort entry point is a five-minute action: open one Take Action campaign, add a sentence about your patients, and submit the prewritten letter. A higher-effort next step is scheduling a district office visit with your Representative or a state legislator during a recess week.1 Bring a one-page summary of the issue, a patient story without identifying details, and a clear ask.
Tracking the 2026 advocacy scorecard is not a post-event recap; it is how speech-language pathologists know whether patient access policies for federal speech therapy programs are actually moving.
An advocacy scorecard converts bill movement, cosponsor counts, and CMS rule finalization dates into a simple status check. Bill movement means whether a proposal has advanced from introduction to committee and floor action. Cosponsor counts show whether a telehealth or scope-of-practice bill has the support to survive. CMS rule finalization dates mark the point where draft Medicare language becomes a binding payment decision for the next year.
The most reliable place to follow updates is ASHA's advocacy page and Take Action portal, where current bill statuses and action alerts are written for SLP audiences rather than policy insiders. State association newsletters fill the gaps, especially for state-level mirror bills and local testimony windows. Set a monthly check-in when Congress is not in a crunch, and shift to weekly monitoring during committee markup or the days before a rule's comment deadline. That rhythm keeps tracking practical instead of overwhelming.
The next major milestone is the 2027 Medicare Physician Fee Schedule final rule, which sets Medicare coverage for speech therapy seniors, typically released by early November 2026 after a proposed rule and public comment period. Payment and coding changes in that final rule take effect January 1, 2027. If ASHA's 2026 advocacy focused on evaluation time, teletherapy parity, or supervisory billing rules, this is the document that tells SLPs whether those priorities became tangible Medicare policy.
This is why tracking outlasts the Hill day itself. A bill that stalls one committee vote short of markup is a specific request for more letters and calls, not a reason to stop. A final rule that improves or limits a speech therapy service code is the real-world lever on patient access, because it changes what clinicians can bill, how they can deliver care, and whether patients can keep their appointments.
