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Speech Therapy denials: what the review data shows
Independent reviewers have decided 860 published cases where an insurer denied Speech Therapy — and they overturned the insurer 73% of the time. A denial for Speech Therapy is a starting position, not a final answer.
Published decisions
860
2001–2026
Overturned
73%
628 denials reversed
By condition
Published outcomes when Speech Therapy was denied for these conditions.
| Condition | Decisions | Overturned |
|---|---|---|
| Autism | 238 | 73.9% |
| Speech Delay | 143 | 86% |
| Autism Disorder | 50 | 60% |
| Articulation Disorder | 26 | 50% |
| Language Delay | 26 | 96.2% |
| Expressive Language Delay | 20 | 95% |
| Down Syndrome | 15 | 100% |
How to use this in your appeal
These are outcomes from California’s external review program — an independent physician panel that binds the insurer. Every state has an equivalent process, and internal appeals succeed even more often. Cite the outcome record for Speech Therapywhen you appeal: reviewers routinely find that denials like yours didn’t hold up.
SOURCE: CALIFORNIA DMHC INDEPENDENT MEDICAL REVIEW OUTCOMES (CHHS OPEN DATA) · DERIVED AGGREGATE STATISTICS ONLY · METHODOLOGY
Not legal or medical advice. Coverage Rights is a self-help tool that helps you prepare your own appeal. For advice about your specific situation, talk to a licensed attorney or your doctor.