A Major Medicare Rule Change is Impacting New Speech Therapists: Here's What You Need to Know

Published on 23 June 2025 at 13:01

A recent policy update from Medicare is causing significant challenges for new graduates in the speech-language pathology field. The Centers for Medicare & Medicaid Services (CMS) has changed its definition of a "qualified SLP," a move that directly affects recent graduates, their employers, and patient access to care.

If you are a Clinical Fellow (CF), an SLP student, or a practice owner, this is news you need to understand. Here is a clear breakdown of the situation.

What Is the New Rule?

Before this change, the rules offered some flexibility for new therapists completing their supervised professional experience, known as the Clinical Fellowship year. The new interpretation by CMS is much more strict.

Under this new policy, a therapist practicing with a provisional or temporary license—which includes almost all Clinical Fellows—may no longer be considered a "qualified provider." This means they may not be able to independently bill for the services they provide to patients with Medicare Part B.

In simple terms, it has become much harder for new SLPs to treat patients in outpatient settings covered by Medicare Part B.

How This Affects the SLP Community

This isn't a small change; it creates immediate, real-world problems:

  • For Clinical Fellows: This rule creates a great deal of uncertainty. It could limit job openings in private practices, outpatient clinics, and other settings that see a lot of patients with Medicare Part B. It also makes it harder to find a placement to complete the fellowship year required for ASHA certification (CCC-SLP).

  • For Employers: Clinics that depend on Clinical Fellows to provide care are now facing major staffing and billing problems. This could lead to disruptions in patient care and create serious operational hurdles, especially for clinics in areas that already lack enough providers.

  • For Patients: This change could ultimately reduce access to necessary speech, language, and swallowing services, as the number of therapists recognized by Medicare shrinks.

ASHA's Response and How They Are Fighting Back

The American Speech-Language-Hearing Association (ASHA) understands how serious this issue is and is taking action. ASHA is actively petitioning CMS to change this interpretation, arguing that it creates an unfair barrier for the next generation of therapists. They are providing guidance and updates to members and leading the effort to ensure Clinical Fellows can continue to provide the care their patients need.

What Should You Do Now?

  • If you are a Clinical Fellow or an SLP Student, it's vital to stay up-to-date through ASHA's official channels. When you apply for a CF position, you should be ready to ask potential employers how they are handling this new Medicare rule.

  • If you are an employer, you should immediately review the latest guidance from ASHA on this topic. It's important to explore different supervision and billing models to stay compliant while still supporting your Clinical Fellows.

This situation is still developing, and it is important for the therapy community to work together and make its voice heard.

Frequently Asked Questions (FAQ)

1. Who does this Medicare rule change affect the most? It most directly affects new SLP graduates during their Clinical Fellowship (CF) year who are treating patients covered by Medicare Part B, which is common in outpatient clinics and private practices.

2. Can I still earn my ASHA Certificate of Clinical Competence (CCC-SLP)? Yes, the requirements for ASHA certification have not changed. However, this rule makes it more difficult to find a CF position that can accommodate the new billing restrictions.

3. Does this rule affect therapists in schools? Generally, no. Most schools bill Medicaid or private insurance, not Medicare Part B. However, any facility that does serve Medicare Part B patients, even if it's a small number, will need to address this policy.

4. What is ASHA doing to fix this? ASHA is actively advocating with CMS to reverse this policy interpretation. They are also providing resources and regular updates to members to help them navigate the situation.

5. How can I stay informed or get involved? Follow ASHA's official news outlets, like The ASHA Leader and ASHAWire. You can also subscribe to newsletters like Therapy Insight to get clear summaries of major policy changes like this one.

6. Does this change apply to Medicare Part A (e.g., in a hospital or SNF)? The rule change specifically targets Medicare Part B (outpatient services). The rules for services billed under Medicare Part A in facility settings can be different. Employers in these settings should verify their specific requirements.

7. Why did CMS make this change? CMS stated the update was made to align Medicare policy more closely with existing federal law regarding the definition of a licensed speech-language pathologist.

8. What is a "provisional license"? It's a temporary license that allows a new graduate to practice under supervision while they complete the requirements for full licensure, such as the Clinical Fellowship year.

9. What can employers do to support their CFs right now? Employers should explore alternative supervision models to ensure compliance. For example, ensuring a fully licensed SLP is always available to guide and direct services may be required. Reviewing ASHA's specific guidance on this is the best first step.

10. Is this rule change permanent? The policy is currently in effect. However, with strong advocacy from ASHA and the therapy community, there is a possibility that CMS could amend or clarify its interpretation in the future.

References

« 

Add comment

Comments

There are no comments yet.