Speech Therapy EMR: What Pediatric SLP Practices Should Look For

Last updated: September 10, 2026

A speech therapy EMR for a pediatric Medicaid practice has two jobs. It has to make notes fast, and it has to produce a chart that holds up when a state agency or managed care plan asks to see it.

This guide covers what to look for, with audit readiness first. It also covers January 1, 2027, when CPT 92507 goes away and speech treatment moves to timed codes.

1. Why audit readiness comes first

Every Medicaid provider agrees to keep records showing the extent of the services it furnishes and to hand them over on request (42 CFR 431.107).

In Florida, the state isn't the only reviewer. Each Medicaid managed care plan must run a fraud investigative unit or contract out that work.

2. What Florida Medicaid expects in the record

State rules differ, and Florida's are specific. Rule 59G-1.054 sets these requirements for Florida Medicaid providers.

1. At every visit

   Document it. Each visit's record must include items such as the date of service, services rendered, diagnosis, progress reports, and the treatment plan where applicable.

2. Within two business days

   Sign it. Each medical record must be signed and dated within two business days from the date and time of service. Electronic signatures are permitted.

3. For at least five years

   Keep it retrievable. Electronic records must be producible in paper format within a reasonable time when AHCA asks, and records must be retained at least five years from the date of service.

Speech-specific requirements sit in Florida's Speech-Language Pathology Services Coverage Policy, adopted by Rule 59G-4.324.

3. Seven things to look for in a speech therapy EMR

Each one shows up at a different point between booking the session and handing over the chart.

1. ScheduleSetting and authorization
2. NoteGoals, fresh data, required fields
3. Sign and lockSigning alerts and audit log
4. Claim and chartPlace of service and export

• SLP-built templates. ASHA says templates adapted from other disciplines often lack the focus a speech note needs, and checkbox-only templates can miss what's unique about the patient. Look for fields for cueing level, accuracy against the last session, caregiver coaching, and the goal each activity targets.

• Required fields and signing alerts. A note shouldn't sign until your payer's required elements are there. Unsigned notes should show up by age, with a warning before the signing window closes.

• Locked notes and an audit log. ASHA says corrections go in as dated entries with the author and reason, never erased. HIPAA requires audit controls that record activity in systems holding patient data, so ask the vendor to show you the log for one note.

• Copy-forward that forces fresh data. ASHA treats repeating earlier activities without noting changes as documentation that doesn't show skilled care. Goals can carry forward, the session data can't.

• Goals and authorizations in the note. Each note should pull from active plan-of-care goals. When a payer requires prior authorization, visits and date ranges should be tracked by child and discipline, so a session outside the auth shows up before it's billed.

• Home, school, and caregiver support. The CMS place of service codes are 11 for an office, 12 for home, and 03 for school, and the right one should flow from schedule to claim. ASHA's guidance also has the note record caregiver training and how the caregiver responded.

• One-package chart export. Florida's rule has providers send legible copies at their own expense when an agency asks. One child's full chart, with signatures and addenda, should export in a single step.

4. Plan for the 2027 speech codes

ASHA reports that CPT 92507 will be replaced January 1, 2027. Ten timed codes replace it, and each treatment area pairs a base code for the first 30 minutes with an add-on for each additional 15.

The Washington Speech-Language-Hearing Association notes that Medicaid and commercial payer implementation isn't known yet. Capture start and stop times on every note now, and ask your vendor for a date to load the final codes.

Frequently asked questions

This article reflects TheraPlan's reading of publicly available guidance as of September 10, 2026. It is not legal, billing, or clinical advice. Codes, coverage, rates, and payer requirements change and vary by state, plan, and contract. Verify current requirements with the payer and the relevant agency before you act, and consult a qualified professional for your specific situation.