CMS's NEW Pediatric G Code Explained: What Every SLP Needs to Know

CMS surprised speech-language pathologists with a proposed pediatric G code, creating new questions about reimbursement, billing, and the future of pediatric speech therapy.

In this episode, Jeanette Benigas, PhD/SLP, is joined by billing expert Rick Gawenda and pediatric private practice owner Emily Watkins, MCD/SLP, to break down what the proposed G code actually means, who it applies to, and why it matters far beyond Medicare.

Topics include:

• Who the proposed pediatric G code applies to

• Why commercial insurance and Medicaid may choose different billing paths

• Timed CPT codes vs. the proposed G code

• How reimbursement could change for pediatric practices

• Operational challenges for clinics and business owners

• Why giving payers multiple billing options may create inconsistencies

• The risks surrounding untimed codes and future payer audits

• Why understanding RVUs and practice expense matters

• What clinicians and practice owners should consider before submitting comments to CMS