Paying for therapy, made simple.

If your plan applies these services to a deductible you have not met, you may be responsible for the full BCBS contracted amount for each covered service until your deductible is met. After that, a copay or coinsurance may apply. Your cost depends on your remaining deductible, benefits, and the services provided.

Depending on your child’s needs, it may be helpful to evaluate more than one area, such as speech and language, fluency, feeding and swallowing, or AAC. We will discuss the recommended services and estimated combined cost before proceeding.

We will provide an estimate for your recommended evaluation services before scheduling, including any additional areas we recommend assessing.

Please contact your insurer before beginning evaluation or therapy services. We can explain the services we recommend, but we are not insurance billing specialists and cannot interpret or guarantee every plan’s benefits.

1. Call Member Services using the number on the back of your insurance card. Have your child’s member information ready. Ask us for the treating provider’s name, NPI, billing information, and proposed procedure codes before calling.
2. Say: “I’m checking my child’s benefits for outpatient speech-language pathology at Little Luminaries Therapy Services. Can you confirm that this provider and location are in network for my exact plan?” Ask separately about telehealth if you plan to use it.
3. Ask whether your child’s recommended speech/language, fluency, feeding/swallowing, or AAC evaluation and treatment services are covered. Ask about exclusions related to diagnoses or developmental conditions and whether habilitative services (helping a child learn new skills) are covered.
4. Ask: “How much of my deductible remains? What would I owe for each proposed service before and after meeting it? Does a copay or coinsurance apply? How much remains before the out-of-pocket maximum?”
5. Ask whether a referral, prescription, prior authorization, or treatment-plan approval is required, who must obtain it, and whether evaluations require separate approval. Ask about visit limits, whether speech/OT/PT share a limit, and whether evaluations count toward it.
6. For AAC, ask about evaluation and therapy benefits separately from coverage for the speech-generating device. Ask whether the device requires a particular equipment supplier, a trial, or additional authorization.
7. Record the representative’s name, call date, and reference number. Request written benefit information when available, and share relevant requirements with us before care begins.

A benefits quote or authorization does not guarantee payment. Your insurer makes the final coverage determination when it processes the claim.

You are responsible for applicable deductibles, copays, coinsurance, and other amounts that your plan and our provider agreement permit us to bill to you. If BCBS applies the full contracted amount to your remaining deductible, that amount may be your responsibility. If a claim is processed differently from the original estimate, you may owe an additional patient-responsibility balance.

We do not bill you for contractual write-offs or charges that our provider agreement prohibits us from collecting. If a service is expected to be noncovered, we will discuss the cost and any required written financial agreement before providing it. Please let us know about changes to your insurance before your next appointment.

We’ll discuss which session length fits your child’s needs and your family’s goals. Private-pay speech and language evaluation pricing is quoted during your consultation based on the evaluation recommended. Caregiver-only consultation and coaching are available privately; ask about the appropriate session length and fee.

Augmentative and alternative communication (AAC) gives children additional ways to express themselves. Our two-step evaluation helps us understand your child and explore communication systems that fit their everyday life.

Step 1: Getting to know your child ($250, 60–90 minutes)

We build a holistic picture of your child’s strengths, interests, current communication, access needs, and daily routines. Through parent interview, observation, and interaction, Dr. Taylor learns how your child communicates now and what your family hopes AAC will support. She also introduces you to multiple AAC devices and communication options.

Step 2: Device trials and funding support ($250, approximately 60 minutes with your child)

During a play-based evaluation, we trial several speech-generating devices or systems to explore which options fit your child’s communication and access needs. This fee also includes the work completed outside the visit: a detailed written evaluation and funding report, coordination with the selected AAC company, and follow-up on documentation requests for the initial funding application.

The evaluation fee does not include purchasing a device. Device availability, trial arrangements, and funding decisions depend on the supplier and funding source; approval is not guaranteed.

After the evaluation

Ongoing AAC training and therapy help your child and family use the chosen system in everyday life. These visits are billed separately at the private-pay therapy rates, or according to your benefits when using accepted insurance.

Families must obtain the program’s required pre-approval before services begin and follow current IEA payment and expense-reporting requirements. Provider approval does not automatically approve every service or expense for every child.

• Tennessee IEA program information
• Current IEA handbook