Calling all speech therapists & moms of kids in speech: Cost of initial evaluation?

[sewarsh]

Looking for opinions here...

At the recommendation of our pediatrician, I had a speech evaluation for our son performed at a local reputable Hospital.

I received the bill last week and it was for $594 which was adjusted by insurance to $397 - which we have to pay since we have a High Deductible Health Plan.

Anyways, my question, does a 60-minute speech evaluation warrant this much of a price tag? It seems exorbitant to me, but I wanted to get some opinions. The Therapist basically said my son is a mumbler and fast talker and has no linguist problems so she doesn't think any additional services (we currently get 30 minutes speech therapy once a week, paid for by our County) were warranted.

Even if it doesn't seem appropirate, I'm not sure what I can do about it now. I mean can you actually dispute a charge? I guess I'll wait to see what some of you think.

Thanks for any opinions.

[niccig]

60 minutes is face time.

Then there's the time to score a formal speech and language test if one was given. Some of these are very complex, multiple sub tests and take time to score.

Then there's the time to transcribe and analyze the language sample. Normally tape recorded conversation that has to be transcribed sometimes phonetically, and can be analyzed a number of ways to see if language appropriate for age.

Then there's the time to write a report, including observations during the 60 mins face time, and write recommendations.

You only saw the SLP for 60 mins, but they did put extra work into your son's case

Now as for if that was too much, I think it varies by area. A friend post on facebook about costs of speech therapy and several of her friends replied with clinics that cost less, so I do think it's one of those situations where you need to look around and ask for fee structure up front. I took DS to a private clinic that didn't accept insurance and it was cheaper than my friend had at a clinic that took insurance. Though, I had to submit to insurance and then fight for it to be covered (they told me on phone it would be), so maybe my friend got a better deal in the end.

[PZMommy]

My son had a speech eval at a local college with a speech and language program. The eval was done by a masters level grad student with a supervisor. It was $325, and that was with a discount because I was a alumni of that college.

[cuca_]

I think it depends on where you live. We used to be in the NY area and this would have been perfectly acceptable there. We are now in the Midwest, and my DS just had a speech eval, and if I remember correctly we paid about $250 or $260.

I am surprised they did not discuss pricing with you when you scheduled your appointment.

[redhookmom]

What about early intervention? Where I live the eval and therapy would be free. My son had early intervention for fine motor skills. I highly qualified therapist came to our house once a week.

[Seitvonzu]

we had my daughter evaluated and we were told that the evaluation was around 200 dollars if the insurance didn't pay it (they didn't expect them too, but they did). so i would certainly have thought that bill was high, and that even the insurance's adjusted rate was high.

our insurance pays only 37 dollars or so for our appt. i pay 20. that doesn't seem even close to the 109 i'd pay myself if insurance wasn't picking it up. they actually are going to start charging insurance the "normal" insurance rate (self pay people get a 'break" i guess... .i dont' know i'm just super grateful it's being paid because even 109 a week , never mind 218 b/c we go twice a week would be a real stretch)

[mytwosons]

DS1 had speech at a local hospital. They charged $240/hour for ST and IIRC, the evaluation equalled three hours of time.

Now, that was before he recieved his autism diagnosis, so insurance paid everything except our co-pay. (Once he was diagnosed, insurance covered nothing.)

[megs4413]

sounds about right to me. it's astronomical to pursue speech services privately.

[niccig]

DS1 had speech at a local hospital. They charged $240/hour for ST and IIRC, the evaluation equalled three hours of time.


My friend I posted about upthread got similar quote. I had DS seen by SLP at
private clinic and it was $150 an hour. I think hospital clinics cost more per hour. Hospital and outpatient clinics also seem also to be more medical/physical causes of the speech language disorder. I was dealing with a client and read something from the report from Kaiser, my clinic supervisor (I'm in grad school to be a SLP) made a comment and when I asked for more clarification, she told me Kaiser won't work with developmental delays in kids, it needs to be a medical reason for them to see the child. They'll evaluate, but will refer them to someone else for services.

So depending on the underlying issues, you may be able to go to a private clinic, and it might be cheaper per hour. Not all private clinics accept insurance, so you have to submit claims and deal with that.

[waitingforgrace]

I'm in Chicago "way out there" suburbs. We pay $180 per hr for our private speech. Not sure what the eval was because we had met our family max OOP last year.

[kristac]

When we went to get DS evaluated we were told the eval at the private practice we were referred to would be $600 and our insurance would not cover it. We ended up using Early Intervention, their evals are free and services are provided on a sliding scale. So sadly yes- for an eval it is more expensive. Perhaps they will work with you?

[schrocat]

Going through the school district to get an evaluation should be free.

The private evaluation for my son cost about $295 (not really sure about the cost... this is what I remembered from seeing the paper). It was 100% covered by health insurance.

Private speech therapy - half an hour a week cost $120 (100% covered by health insurance).

[mom2binsd]

I'm an SLP but don't do private practice, but I agree that the 60 min eval could end up in 2 hours of transcription/report writing/other admin tasks. As well, if it's in an office they have office rent etc to cover that will be built into the cost. If they used a formal test then there are also associated costs (one of the simple articulation tests costs about 300 to purchase plus the necessary test forms, so you can see where the cost of private practice adds up.)


An eval costs more than therapy as there is more involved. I would have thought they'd have mentioned the cost, but maybe they only do if you ask.

When I did a small amount of private practice in Canada back in 1995 I charged 80.00/hour, that amount was pretty standard as Canada has some laws that regulate how much you have to charge (min and max) so as to not create an unfair market for "cut rate" therapists.

I think the costs vary widely, and I always encourage parents to pursue Early Intervention or the public schools when needed. I also think using a clinic associated with a grad program is great idea, some of the best therapy is provided by eager grad students who spend hours prepping and making a therapy plan that is reviewed by a Professor/SLP. Private SLP's vary in cost and in my opinion quality. One local SLP was charging crazy rates for children to be a part of a commercial program that she had an unqualified office worker administer.....it was a savvy parent who figured this out, she figured because this person had a nice office, ads in local parenting magazines that she was a good therapist, a co worker briefly worked there but quit because of issues like this. So like anything else it's buyer beware.

[sewarsh]

I'm very upset about this - I knew whatever the charge was, we'd be on our own to pay it because of our High Deductible plan, but I think $400 is outrageous!

For more background, our DS has been receiving speech 1x per week for 30 minutes since the beginnning of 2012, paid for by the County through our Intermediate Unit/Early Intervention. At DSs 4 YO well checkup, our pediatrician referred me to this Hospital group for further evaluation because she felt he needed more therapy. The Speech Therapist at the IU said he didn't and the ST at the Hospital agreed.

I didn't realize different "shops" charge different amounts. Is there a way to pursue this so to get the cost lowered? or is that a ridiculous thought?

I guess I have to chalk this up as a lesson to be learned.

[kijip]

T goes 2 times a week to a Speech and Language office (private practice), mainly for social cues and verbal response type stuff due to his autism. All visits including the first meeting were billed at the same rate. There was no extra fee for evaluation whatsoever. Perhaps that is because they are not trying to tackle any enunciation issues? He speaks well, but he just doesn't clue into conversations the same way. We are fortunate that it is covered by insurance so we just pay a co-pay.

[smilequeen]

Yes, that sounds correct to me. We paid somewhere in the range of 450 for the eval for DS2. We are doing all of his speech privately as he goes to a private school and I prefer to have someone who can work with him there.

[ett]

I didn't realize different "shops" charge different amounts. Is there a way to pursue this so to get the cost lowered? or is that a ridiculous thought?


I'm sorry about the charge being so high. It's just all very expensive! Since you're already getting a discount through the insurance, I don't think there is any way to get the cost lowered. I know many places have lower costs if you pay out of pocket, but then the amount won't be applied to your deductible.

[kijip]

You could ask them if you could pay it 1/2 now and 1/2 in a month. Most places are willing to work with you on short term payments.

[Neatfreak]

DD2's was $600; the eval was comprised of two meetings (the first was about 50 minutes, the second about 30 minutes), and we were given a report.