Phone: 503-421-8629 | Fax: 888-425-0586 | hello@inreachspeech.com
Insurance and Rates
We are in-network with the following health plans:
- All BlueCross BlueShield plans
- MODA
- Pacific Source
- Care Oregon
We strongly encourage contacting your plan to get confirmation for coverage of speech and occupational therapy services. We verify insurance at the start of care; however, it can be difficult to determine exactly what your plan will cover until claims are processed. We will work with you to understand your coverage, and we will always advocate for the maximum benefit for your child.
Attention Medicaid members: As of January 1, 2023, we will no longer accept OHP Open Card, Intercommunity Health Network, or Pacific Source Medicaid lines. We also cannot accept Medicaid plans under CCOs which require contracting.
Out-of-Network Billing
Please note that we are unable to provide out of network billing at this time; however, we can provide you with a superbill (a form which provides all pertinent information for your insurance plan) and will counsel you to seek reimbursement from your plan.
Private Pay Rates Available
SPEECH THERAPY:
Evaluation: $325 - $445
Initial evaluations for speech therapy are comprehensive and assess speech, language, cognition, and oral motor/feeding. The cost includes assessment at home or preschool, a thorough evaluation report, and collaborative development of a treatment plan with long and short-term goals. Please allow 1.5 - 2 hours for initial speech therapy evaluations.
Treatment: combination of charges according to areas of need
$95 Speech/language
$100 Feeding/swallowing
$140 AAC, speech-generating device
$45-90 Cognition
Treatment sessions are typically 30-minutes in duration, and address the goals created in collaboration with caregivers. All treatment sessions are conducted in the most functional and relevant setting for the child and with an individualized, play-based approach. We additionally provide a weekly summary via email to review strategies that can be applied outside of therapy to optimize progress.
Extended sessions: If your child's needs are more complex and require treatment in areas in addition to speech and language, we may advise extended sessions up to 60-minutes in duration. Cost will vary depending on the additional areas of need. Please reach out to us for more information.
OCCUPATIONAL THERAPY:
Evaluation: $200
Initial occupational therapy evaluations assess fine motor, sensory, adaptive, and cognitive skills. The cost includes assessment at home or preschool, a thorough evaluation report, and collaborative development of a treatment plan with long and short-term goals. Please allow 1 hour for initial occupational therapy evaluations.
Treatment: $160
Occupational therapy treatment sessions are typically 1 hour in length, and address the goals created in collaboration with caregivers. All treatment sessions are conducted in the most functional and relevant setting for the child and with an individualized, play-based approach. We additionally provide a weekly summary via email to review strategies that can be applied outside of therapy to optimize progress.
How does insurance work for therapy services?
Commercial versus Medicaid
Commercial plans
- Therapy providers must contract with commercial plans to provide therapy to members of the plan as an in-network provider on their panel.
- If the provider is contracted as in-network, services provided often require less paperwork to initiate services and cost to the member is often less than out-of-network benefits.
- Sometimes panels are closed and new providers cannot contract with the plan.
- Some plans have the same, or similar, coverage for out-of-network benefits as in-network benefits. This is very plan-specific. If you do not know your in-network and out-of-network benefits, please contact us and we will send you a detailed breakdown!
Medicaid Plans
- It is illegal for providers to charge anyone with Medicaid coverage. This means that private-pay rates are not available for Medicaid members.
- Medicaid plans are overseen by different coordinated care organizations (CCOs), which are assigned by geographic region. The Oregon CCO map is here.
- Under the CCOs are the Medicaid plans. For example, in the Portland area, Health Share is the CCO, and there are four plans that Health Share coordinates (Kaiser, Providence, OHSU, Care Oregon).
- OHSU is the only open plan in the Portland area, so if you have Kaiser, Providence, or Care Oregon, you may only see providers in their network OR request a single case agreement to see a provider who is out-of-network. Single-case agreements may be granted if there is medical necessity for services due to inadequate representation for specific needs within the plan's network.
- If you feel that the in-network providers for your plan are insufficient for your needs, YOU CAN CHANGE YOUR PLAN at any time.
Your health, your choice
As a Health Share member, you can choose the health plans and providers that are right for you and your family. No matter which health plans you choose, your benefits are the same, and they’re available at no cost to you.
Your health plans and primary care provider (PCP)—that’s your main doctor—are listed on your Member ID Card. You can switch health plans if you want—just call 503-416-8090 or email info@healthshareoregon.org.
To change your doctor, dentist, or other care provider, contact your health plan.
When you have both commercial and Medicaid coverage:
- Your commercial coverage is the primary and your Medicaid coverage is the secondary.
- This means that Medicaid will pick up any cost not covered by your commercial plan
WANT to apply for Medicaid?
- Click here to complete the screening questions.
- Need help with the application? Click here.
- Click here to be directed to the forms to apply for OHP (medicaid).
As part of our mission to break down barriers to care, we offer full-service counseling regarding insurance benefits.
