Payment and Insurance

Polyphonic Speech Services is a self-pay clinic. Clients pay us directly for services. Payment is due at time of service. Clients have a card on file with us. This can be a credit, debit, FSA, or HSA card. That card is charged automatically at the end of each session. The charges show up discretely on your monthly card statement as “professional services.”

This means that we do not accept direct payment from any insurance plan/company. We are not ‘in network.’ We are ‘out of network.’

Base Costs

20-Minute Consultation, $0

If you are ready to change your voice, but unsure if Polyphonic Speech or voice therapy is right for you, start here. This is an opportunity to meet your potential voice therapist and have your questions answered before committing to an evaluation.

60-Minute Voice Evaluation, $100

If you are committed and ready for voice change at Polyphonic Speech Services, start here. When you schedule a voice evaluation, expect the following:

Schedule online: Using the ‘Request Appointment’ button at the top of this page, schedule yourself a voice evaluation at a convenient time.

Before your appointment: You will receive an email that confirms your appointment. You will receive access to a secure, online, client portal. In the portal, you will be prompted to acknowledge practice policies (such as the attendance policy), complete questionnaires to help us understand your voice problem, and provide payment information. These forms must be completed 24 hours before your appointment.

During the appointment: The voice evaluation will take place over Zoom. A voice evaluation has five parts:

1) Introductions. We start by introducing ourselves and checking in. How are you feeling? Nervous? Excited? Is there something we can do to help you feel at ease?

2) Voice evaluation. Your voice therapist will ask you to do a few things with your voice. For example, pitch glides or saying ‘ah’ for as long as you can. These things might seem a little strange to do, but they help us hear where your voice is starting off. You’ll have a chance to practice these things with your voice therapist and then your voice therapist will take a recording of your voice doing these things.

3) Analysis. While your voice therapist runs an analysis of your voice recording, you and your voice therapist will talk about your experience doing those things. For example, “what did you notice about your voice while you did that?” or “were there points in there where you felt your voice was sounding better or worse?”

4) Goals. At this point, we’re ready to set goals. Voice goals are personalized to what you want to accomplish with voice therapy. This might be to achieve a “cis-assumed” or “passing” voice, to sound more natural, to speak with more confidence, to feel more aligned with your voice, etc. Sometimes, people come to voice therapy with very specific goals in mind. Other times, goals start more general and are refined later.

5) Approach assessment. With your voice starting point and voice goals in mind, we will spend the rest of the evaluation time trying out different voice therapy approaches. That way, we can see what sort of voice therapy approaches you respond best to and which approaches will best help you accomplish your goals.

45-Minute Voice Therapy Session, $100

Voice therapy sessions follow the voice evaluation.

There are three parts to a voice therapy session:

1) Home Exercise Program review and troubleshoot. We’ll spend the first ~5 minutes reviewing the home exercise program from last session. How did it go? Which parts went smoothly and which parts were difficult?

2) Voice skills training. The bulk of the session time is spent learning new voice skills. This might include learning to shift pitch, resonance, intonation patterns, voice weight, articulation, etc. with healthy and sustainable techniques. Or, a session might target ways to sound more masculine or feminine when laughing or coughing. We might also learn how to critique vs. criticize a voice recording. Or, we might explore how to authentically express emotions in a new target voice. We might also troubleshoot why it’s easy to use the new voice in these sessions but difficult to use the new voice in the real world, identifying barriers and generating solutions.

3) Recap and Plan. In the last ~5 minutes, we will review the session and make sure we’re ending on the same page (“what did we do today, and what did you get out of today”). We will collaboratively decide on a home exercise program for you to work on between now and the next session. Finally, we’ll schedule the next appointment.

The majority of clients meet their voice goals in 5-15 sessions. Voice therapy ends when you graduate yourself.

Sliding Scale & Superbills

A limited number of sliding scale slots are available for clients experiencing economic hardship. Inquire at a consultation if you would like more information about our current sliding scale rates, eligibility, and availability.

Under the federal No Surprises Act and the state-level laws in the states where we practice, self-pay clients are entitled to a written breakdown of expected costs. We will provide this to you when you schedule an evaluation or upon request.

Upon request, we will provide clients a detailed receipt called a ‘superbill.’ Superbills can be submitted to your insurance for potential out-of-network reimbursement or potentially to count towards your out-of-network deductible. See the section below for more information.

Out-of-Network Benefits

Even through Polyphonic Speech Services is self-pay only, clients can seek reimbursement through their insurance, after services are rendered. We strongly encourage clients to investigate their health insurance policies prior to evaluation, in order to see if your plan may or may reimburse services.

Verifying via Phone call. On the back of your health insurance card, there is a customer support number. Explain to the representative that you are calling to see if your plan will cover certain services. Tell the representative that you are scheduling a voice evaluation (CPT 92524, modifier: 95) and subsequent voice therapy sessions (CPT 92507, modifier 95) via telehealth with an out-of-network speech-language pathologist. The expected diagnostic code is ICD 10 R49.8 “voice/resonance disorder.” The representative may ask why you’re seeking voice care in general and specifically with this out-of-network provider. If it is true for your situation, you might respond that your voice is negatively impacting your quality of life, that this company is trans voice therapy focused and you feel you need a specialist rather than a generalist speech-language pathologist, telehealth is necessary due to a lack of in-person options, etc. Inquire specifically if you require a prior authorization, if you require a referral letter from a mental health professional or a physician, the steps to submit your superbills, and any limits on the number of sessions. Inquire how those superbills would count towards your out-of-network deductible and how much per session would be reimbursed.

Why Clients Choose Self-Pay

There are several key reasons someone might choose self-pay for voice therapy instead of using insurance, including getting the best care at an affordable price.

1) Choosing to work with a specialist. When you choose to use your in-network benefit, you are restricted to the speech-language pathologists in that network. Gender-affirming voice therapy is a niche practice area. Many SLPs do not have the additional training and competency to practice in this area. Gender-affirming voice therapy is all that we do here.

2) Choosing to work with a professional who carries a sustainable caseload, and is accountable to you. I set a limit on the number of clients that I will take at a time and a limited number of sessions per week that I will offer. This allows me to bring real energy and presence to each client that I work with.

3) Choosing personalized care. When you self-pay, we can go beyond the limits of what insurance will cover. Voice therapy can take as long as needed, at a pace that works best for you. We can work on goals that are vital to you but that your insurance might consider not ‘medically necessary’.

4) Choosing maximum privacy. Clients may prefer not to share that they are transgender or pursuing voice therapy with their health insurance company. Clients may prefer their medical history does not include ‘voice/resonance disorder.’

5) Choosing clear costs and no surprises. You know the session rate upfront and pay as you go. It’s as simple as the session rate is the session rate, and the late cancellation fee is the late cancellation fee. There are no hidden fees. There is no dealing with denied claims or unexpected copays or coinsurances. Our payment structure makes it impossible for you to rack up a large surprise bill.

6) Choosing care over no care. Unfortunately, many health care plans simply do not cover gender-affirming voice therapy. Sometimes, self-pay is the only option.