Points of interest…
- In 2027, 10 new treatment codes will replace CPT 92507.
- ASHA members held over 175 Hill meetings and delivered 6,000 letters.
- ASHA pushes Congress to protect Medicaid, IDEA, and research funding.
How SLPs Can Speak Up for Speech Therapy Access, Starting Now
Turn Capitol Hill momentum and the 2027 billing shift into real advocacy steps
On September 23, 2026, more than 150 ASHA members carried 6,000 constituent letters into over 175 Capitol Hill meetings, according to a GlobeNewswire release. The immediate stakes are concrete: in 2027, 10 new treatment codes replace CPT 92507, and ASHA has filed comments on the proposed Medicare Physician Fee Schedule.
For an SLP grad student or clinical fellow, that shapes billing workflow, SLP Clinical Supervision time, and patient caseload. Advocacy can start small: know who to contact, share a local story, make a clear ask, and track the office response.
The 2026 Coding Shake-Up: 10 New Treatment Codes Replace CPT 92507
Starting January 1, 2027, the familiar catch-all treatment code CPT 92507 is deleted. In its place, ASHA and CMS describe 10 new speech-language pathology treatment codes organized into five clinical categories: fluency; speech sound production; language comprehension and expression; combined speech sound production and language; and Voice Therapy, upper airway dysfunction, and/or resonance.1
What changes on January 1
Each category has a base code for the initial 30 minutes and an add-on code for each additional 15 minutes. The system is now timed, so units billed depend on minutes spent. Documentation must show which clinical domain was targeted and how much time was spent.
Why coding specificity matters
The old 92507 reported treatment services without distinguishing area or intensity. Moving to more specific codes gives payers a clearer picture, but it may also shift reimbursement. ASHA cautions that shorter single-domain sessions may pay less per session than a full 92507 unit, while longer or multi-domain sessions may pay more. Medicare, Medicaid, and commercial payer implementation is still uncertain.
Three moves to take now
- Training: Learn the new code categories and timed billing requirements before January.
- Systems: Ask your employer or clinical site how they are updating EHR, speech therapy documentation requirements, and billing workflows.
- Readiness: Use ASHA's payer-letter template to confirm how each payer will handle the 2027 transition.
Medicare Fee Schedule Comments, Medicaid, and IDEA: What ASHA Is Pushing For
What do ASHA's September 2026 comments to CMS on the proposed 2027 Medicare Physician Fee Schedule actually ask for, and how would those payment changes touch a clinic's paycheck and caseload?
ASHA filed formal comments on September 14, 2026, focused on the transition from CPT 92507 to 10 new speech-language pathology treatment codes effective January 1, 2027.2 Among the requests: accept the relative value unit recommendations for those replacement codes, withdraw the proposed pediatric G-code because the new code family already covers pediatric treatment, add all 10 codes to the Medicare telehealth list, and publish a separate SLP payment impact analysis instead of a combined therapy-category estimate.
Why the fee schedule reaches the clinic
A proposed 1.68% conversion factor reduction for 2027 would put downward pressure on most SLP and audiology payments even if the new code values are accepted. CMS's proposed national nonfacility payments for the new codes range from about $19.71 to $71.59 per session, with a 30-minute initial code and 15-minute add-on.1 Because payment per unit can affect how many minutes a clinic can afford to schedule, these changes often show up as tighter productivity goals, shorter sessions, or reduced openings for lower-reimbursement patients.
Medicaid, IDEA, and rural access
ASHA also urged Congress to protect Medicaid, preserve IDEA speech therapy eligibility, and fund research. National 2026 Medicaid and IDEA funding proposals with documented effects on rural and underserved speech therapy access are not publicly established; state actions vary. Washington State, for example, preserved Medicaid therapy services in 2026, but that is one state, not a national pattern. For rural and underserved communities, ASHA's warning that continued funding cuts already restrict access to life-changing services remains central to the Speech-Language Advocacy push.
Where to Aim Your Advocacy: Issues, Decision-Makers, and Your Ask
Advocacy works best when you know who sets the rules and what specifically to request. The table below pairs several current policy priorities with the decision makers who can act on them and a concrete ask you can tailor to your setting. Use the best messenger column to decide who should carry the message.
| Issue | Who Decides | Typical Advocacy Ask | Best Messenger |
|---|---|---|---|
| Medicare payment and coding | CMS, with Congress setting Medicare funding and oversight | Support ASHA's comments on the 2027 Medicare Physician Fee Schedule and a smooth transition from CPT 92507 to the 10 new treatment codes | Practicing SLPs and ASHA members sharing how payment instability harms patient access |
| Medicaid reimbursement | Congress and state Medicaid agencies | Protect Medicaid funding and maintain adequate reimbursement for speech-language services, especially in rural and underserved communities | SLPs, clinic administrators, and families affected by coverage cuts |
| IDEA and school-based services | Congress, state education agencies, and local school districts | Preserve IDEA mandates and increase federal funding so schools can staff and deliver speech-language services | School-based SLPs, parents, and special education directors |
| Research funding | Congress and federal research agencies such as NIH and the Institute of Education Sciences | Increase federal research investment in communication disorders and evidence-based speech-language service delivery | SLP researchers, graduate programs, and ASHA |
| AAC access | State Medicaid programs, private insurers, and school districts | Cover AAC assessment, devices, and training without restrictive caps or lifetime limits | AAC specialists, patients who use AAC, and disability advocates |
| Telepractice | State legislatures, licensure boards, and payers that set telepractice reimbursement rules | Maintain licensure portability and payment parity for telepractice speech-language services | Telepractice SLPs and patients in rural or underserved regions |
Why This Matters for SLP Students and New Clinicians
Entry-level CCC-SLP Salaries are shaped by payment policy before you ever sign a contract. When Medicare or Medicaid reimbursement tightens, clinics and school districts may freeze hiring, raise productivity expectations, or reduce the supervision time that new clinicians need. That instability is not abstract; it shows up in caseload pressure and fewer positions in SLP work settings that traditionally hire new graduates.
Billing literacy is now a hiring edge
In 2027, ten new treatment codes replace CPT 92507. A student who can talk through the coding transition and document for the new codes arrives with a practical skill most applicants lack. Supervisors will notice.
Rural and underserved settings feel it first
Many early-career SLPs start in rural schools, home health, or community clinics. Funding cuts hit those sites hardest, so access and job stability move together.
You can get involved now
Student groups can host a letter-writing table, invite a state association advocate to a meeting, or pair classmates to call a legislative office. Short, specific messages count more than polished talking points.
How to Contact Your Legislators and Share Patient Stories, Step by Step
There are two ways to contact a legislator: send an identical message to every office, or make one short, local, specific contact. The first is likely to be skimmed. The second gets logged by district staff and can lead to a meeting.
Find your member and the right staffer
Start with your home address and ZIP code. Use the official congressional directory for federal officials and your state legislature's member lookup for state lawmakers. When you call a district or capitol office, give your name, address, and phone number, then ask which staffer handles health, education, or Medicaid issues. Keep the ask focused on one bill or rule.1
A short email and a 30-second call
For email, put the point in the first paragraph and include your address and a clear request.2 A workable message can be this short: "My name is [name] and I live at [full address], ZIP [code]. I am an SLP student/clinical in your district. Please [support/oppose] [bill number or specific action] because [one sentence on access]. I welcome your office's position."
For a 30-second call, say: "My name is [name] and I live at [full address]. I'm calling about [issue and bill number]. I ask the [representative/senator] to [specific action]. This matters because [one short patient-access sentence]. Can you tell me the office's position?" Answer their questions, then thank the staffer.1
Requesting a meeting and telling a patient story safely
Most offices accept written meeting requests and may offer a staffer rather than the legislator.3 Ask for an appointment, stay flexible on time, and prepare one or two issues. Follow up with a thank-you note that restates your ask.3
Patient stories can move a meeting, but only with explicit permission.3 De-identify the person as much as possible, use the minimum identifying detail, and get written consent when you plan to share a story publicly. Focus on access impact, not diagnosis detail, and stay within trauma-informed care principles when the conversation touches sensitive experiences.
Personal versus professional capacity
Unless your employer or nonprofit has authorized you to speak for it, make clear you are acting in a personal capacity.5 Stay within your job duties and organizational policy;4 do not threaten retaliation or imply the organization will act against a lawmaker.3 That protects both you and your employer.
Related Articles
Using ASHA Take Action, the Action Center, and Hill Day
Which ASHA advocacy tool should you use when you only have 15 minutes to speak up for speech therapy access? The answer is usually the ASHA Take Action Center, but each resource has a specific job.
Match the advocacy tool to the task
- ASHA Take Action Center: Use this to send a prewritten, editable message to your legislators when an alert matches your state, setting, or clinical population.
- Take Action alerts: These flag timely asks such as Medicare telehealth authority, Medicaid cuts, and 2027 CPT code changes. Open them early enough to personalize your note before the deadline.
- Advocacy toolkits: Use these when you need talking points, a template letter, the ASHA Workload Calculator, a State Caseload Chart, or the Working for Change guide.
Hill Day and state-level links
ASHA's 2026 Capitol Hill Day brought members to Washington to meet congressional offices. If you cannot attend, you can still use the Take Action Center to contact legislators, and ASHA's guidance points to [email protected] for scheduling and meeting prep when you are in DC at another time.
For state work, ASHA State-by-State is the more practical entry point: it lists state requirements, contact information, hot topics, trends, and advocacy resources.
A 15-minute starter routine
Set one weekly 15-minute block. Choose one open Take Action alert, add one privacy-safe patient or student example, submit it, then note the issue in your calendar for follow-up. If you work in schools, pair that action with a quick check of your state's ASHA State-by-State page.
State-Level Advocacy: Associations, Medicaid, Schools, Telepractice, and AAC
Some SLP advocates wait for a national fix, but many of the policies that shape daily practice are decided closer to home: in state Medicaid agencies, school regulations, licensure boards, and insurance mandates.
Start with your state association
State speech-language-hearing associations usually structure that work through an executive team, a legislative committee or consultant, and a grassroots network. A designated legislative officer, committee, or consultant often tracks bills and regulations; some states also retain a lobbyist or run a separate political action committee. To find your contact, start on your state association's advocacy or About page rather than assuming a national directory has the latest name.1
Track state-specific policy without guessing
Medicaid reimbursement, school-based speech therapy caseloads, telepractice rules, and AAC coverage are largely state-driven. For a repeatable starting point, use ASHA's state-by-state page, which points to state associations, practice contacts, and advocacy updates. Then cross-check the association's advocacy page for the legislative chair, lobbyist, or committee. Telepractice rules are especially variable because state licensure requirements for telepractice SLPs are usually set at the state regulatory level. AAC advocacy tends to follow coverage and mandated-benefit paths, so look for state-level reimbursement campaigns rather than a single national rule.
Join a committee as an easy entry point
You do not need to be a policy expert. Many associations welcome members onto legislative or reimbursement committees and connect them to ASHA's state advocacy staff, regional liaisons, and member networks such as SEALs, STARs, and StAMPs. That is where you learn the local players and build relationships that make a Hill visit or testimony far more effective.
Hill Visit and Testimony Prep Checklist
Use this checklist for a congressional meeting or short state testimony.
- One clear askName the specific bill, funding line, or regulatory action you want the office to support, leave with a concrete next step.
- Two or three data pointsBring only high-impact numbers, such as a state Medicaid reimbursement rate or rural access gap, to support the ask without overloading.
- A one-page leave-behindPrepare a single page with your name, credential, ask, data points, and contact information for quick reference after the meeting.
- A de-identified patient storyDescribe one clinical example without names or identifiers, connecting the policy change to a real delay in care or lost access.
- Assigned team rolesDecide in advance who opens, who tells the story, who presents data, and who makes the final ask.
- Thank-you follow-up within a weekSend a short email or note within seven days, restate the ask, and offer to be a local resource.
How to Tell Whether Your Advocacy Is Working
Advocacy rarely produces overnight wins, which makes it easy to mistake quiet groundwork for failure. The clearest way to know your effort is working is to track it simply: contacts made, responses received, meetings held, and follow-ups sent. A basic spreadsheet or shared document is enough.
Signals That Count
Realistic signs of momentum include a legislator agreeing to co-sponsor a bill, a staffer asking for more data or a constituent story, or your specific concern showing up in a formal rule comment. None of these is a final victory, but each means your message moved from inbox to conversation.
Watching Access Locally
Pay attention to access indicators in your area: waitlist lengths, reimbursement denials, and caseload sizes. A plateau can still be progress if a proposed cut was delayed or a clinic kept its telepractice option.
What Progress Looks Like in 6-12 Months
Policy change is slow. In a year, progress often looks like two or three new relationships with legislative staff, one cosponsorship, or a state association adopting your data point. That is meaningful, even when the underlying law has not changed.
