WE TRAVEL TO THE FOLLOWING MANHATTAN NEIGHBORHOODS
We also travel to the Bronx, Riverdale, Westchester, New Jersey (NJ), and Connecticut (CT)
MANHATTAN, NYC, SPEECH LANGUAGE EVALUATIONS

We travel to Battery Park City, Central Midtown, Chelsea, Chinatown, Clinton, East Village, Financial District, Flatiron District, Garment District, Gramercy Park, Greenwich Village, Harlem, Hell’s Kitchen, Hudson Square, Kips Bay, Little Italy, Lower East Side, Midtown, Murray Hill, SOHO, Sutton Place, Theatre District, Times Square, TriBeCa, Turtle Bay, Union Square, Upper East Side, Upper West Side, West Village
Please note that we adhere to HIPPA (health information privacy) standards, and all confidential information can not be shared with anyone without your written consent. We also store all electronic confidential information on our HIPPA compliant encrypted email server. Our speech, language, and feeding evaluations are out-of-network and we can provide you with a superbill to submit to your insurance company.
Our Speech-Language Therapists/Pathologists are licensed in the following states:
- New Jersey (NJ)
- California (CA)
- Michigan (MI)
- Missouri (MO)
- Washington (WA)
- Pennsylvania (PA)
- Idaho (ID)
- California (CA)
- Michigan (MI)
- Missouri (MO)
- Washington (WA)
- Pennsylvania (PA)
- Idaho (ID)
- Maine (ME)
- Kentucky (KY)
- Oregon (OR)
- Maryland (MD)
- Washington, DC
- Connecticut (CT)
Please note that we adhere to HIPPA (health information privacy) standards, and all confidential information can not be shared with anyone without your written consent. We also store all electronic confidential information on our HIPPA compliant encrypted email server. Our speech, language, and feeding evaluations are out-of-network and we can provide you with a superbill to submit to your insurance company.
Our Speech-Language Therapists/Pathologists are licensed in the following states:
- New Jersey (NJ)
- California (CA)
- Michigan (MI)
- Missouri (MO)
- Washington (WA)
- Pennsylvania (PA)
- Idaho (ID)
- California (CA)
- Michigan (MI
- Missouri (MO)
- Washington (WA)
- Pennsylvania (PA)
- Idaho (ID)
- Maine (ME)
- Kentucky (KY)
- Oregon (OR)
- Maryland (MD)
- Washington, DC
- Connecticut (CT
We travel to:
Getting Started with us!
If the following is confusing, we will explain everything to you over the phone!
Speech-Language Pathology
Speech Language Evaluation – If you are seeking speech, language, and feeding services, you will need to work with one of our licensed speech-language therapists/pathologists: New York State requires that you work with a licensed therapist skilled in these areas if you or your child needs help with enunciation, expressive (oral) language, receptive (auditory) comprehension, social pragmatic skills, feeding, fluency (stuttering), etc. If the individual does not need help with their oral expressive and receptive language skills or oral expressive language skills, he or she can work with one of our literacy specialists (this is different than working with a licensed therapist) if there are literacy concerns. However, some students have what is called a language disorder (expressive and/or receptive language difficulties) and these students need therapeutic literacy intervention performed by our language therapists. This might be eligible for out-of-network reimbursement. If the literacy intervention is considered language therapy, we will need the right ICD-10 code(s) to justify a language therapy approach to your child's literacy intervention. ICD-10 codes which indicate language therapy include language disorder, expressive/receptive language disorder, phonological disorder, autism spectrum, social pragmatic communication disorder, other developmental disorders of speech and language, developmental disorder of speech and language, and sometimes diagnosis such as a specific learning disorder, a specific reading disorder, or a specific impairment in written expression.
In order to start therapeutic services by our speech-language therapists/pathologists, we need written justification from NY licensed therapists or medical doctors regardless of their affiliation with Manhattan Letters. This documentation typically includes ICD-10 code(s). We will also need current goals. These goals can come from recent reports or from current professionals working with your child. If you do not have any of these codes, we can help!
At Manhattan Letters, we offer a variety of evaluations. Our speech, language, and feeding evaluations are out-of-network and we can provide you with a superbill to submit to your insurance company. We work with all ages including:
- Speech Disorders – These can occur when an individual has difficulty producing speech sounds and putting them together to form intelligible words. Speech disorders include articulation or phonological disorders, apraxia of speech, and dysarthria.
- Voice or Resonance – Voice or resonance disorders refer to problems in how one’s voice sounds. One may sound hoarse, lose voice easily, talk through the nose or too loudly, or be unable to make sounds.
- Social Communication – This refers to the social use of verbal and nonverbal communication. This includes how one communicates socially, how well one follows conversation rules and story-telling (aspect of expressive language called narratives), tells jokes, and how one speaks with different people in varied situations.
- Cognitive-Communication – Someone with a cognitive-communication disorder may exhibit problems with organization, memory, attention, problem-solving, and other thinking skills. This can be a result of traumatic brain injury, a stroke, dementia, and may also be congenital.
- Swallowing Disorders – Also known as dysphagia, swallowing disorders refer to difficulties in chewing, sucking, and swallowing food and liquid as a result of illness, surgery, stroke, or injury.
TODDLERS
Speech sound development is strongly tied to the child’s expressive language abilities and toddlers who are hard to understand can be unintelligible for many reasons A delay in expressive vocabulary and a delay in stringing words together is usually accompanied by a delay in the sound acquisition and decreased speech intelligibility. Therapy typically focuses on increasing the child’s expressive vocabulary and helping the child increase the complexity of what they say. As the child’s vocabulary expands, the number and variety of sounds increase and the toddler is more understood. For toddlers with a limited sound repertoire, we teach early developing sounds to start building the foundation for learning words. Some toddlers are talkative but they are hard to understand. They may need help acquiring early developing sounds and/or eliminating atypical sound errors. Some toddlers can say a lot of words and they are well understood, but they need help using their words in the right environment. Here, the therapy focuses on social language use.
PRESCHOOLERS
Therapy may focus on increasing the child’s vocabulary and complexity of what they say, facilitating their underlying speech development. Some preschoolers need help learning age-appropriate sounds and/or reducing speech error patterns, e.g. child says tiss, for kiss even though the child can say the k sound. Some preschoolers can say a lot of words and they are well understood, but they need help using their words in the right environment. Here, the therapy focuses on social language use.
SCHOOL AGE
Therapy typically focuses on teaching later developing sounds, e.g. th, l, and r, reducing sound distortions, e.g. lisp, and resolving any remaining speech error pattern(s) not exhibited by peers.
About Childhood Apraxia of Speech Language Evaluation
What is Childhood Apraxia of Speech
Childhood Apraxia of Speech (CSA) is a pediatric speech disorder. In contrast to difficulties with articulation (enunciation), a child with Childhood Apraxia of Speech cannot get their mouth movements to the right place at the right time. This will result in not only speech errors but also disruptions to the flow of speech.
Who might have Childhood Apraxia of Speech
Childhood Apraxia of Speech can occur on its own or in combination with other speech and language disorders. Often children with Childhood Apraxia of Speech have not made progress with traditional speech therapy. Some children with Childhood Apraxia of Speech make inconsistent errors when repeating the same word. Sometimes children with Childhood Apraxia of Speech may speak in a way that sounds slow or choppy.
Read about Early Childhood Developmental Milestones.
How is Childhood Apraxia of Speech Diagnosed
Childhood Apraxia of Speech is a misunderstood and often misdiagnosed speech disorder. Childhood Apraxia of Speech is difficult to diagnose because the symptoms can appear very similar to speech-language delays and other speech-language disorders, especially when a child is very young or has a limited vocabulary. There is no gold standard test for Childhood Apraxia of Speech so it must be diagnosed by careful and systematic exclusion of other highly similar speech disorders. Although there is no single test for Childhood Apraxia of Speech, the scientific literature has identified tasks that can differentially diagnose children with high accuracy. Accurate diagnosis depends on a skilled and experienced practitioner to understand and use these science-based methods. Methods for differential diagnosis of CAS from other pediatric speech sound disorders vary by the age and communication abilities of each child. Evaluations of CAS must include an evaluation of the motor speech system, examining in detail both the types and amount of sounds and syllable shapes a child has, in addition to the underlying movement patterns and overall quality of the rate, rhythm, and intonation of speech.
Apraxia Evaluation/Assessments:
- $700-$1000 Apraxia Evaluation performed by Dr. Melissa (see below for more information). She is one of the top NYC experts on apraxia of speech!
About Infant/Toddler/Childhood Feeding
A feeding disorder can occur alongside developmental delays or medical conditions, such as autism spectrum disorder, Down syndrome, cerebral palsy, or respiratory disorders.
Young children with feeding difficulties typically demonstrate a delay in or difficulty swallowing, sucking, chewing, and display food aversions, food refusal, texture selectivity, and food selectivity. Many factors can cause a young child to become a picky eater.
Feeding therapy involves improving the child’s oral motor and underlying feeding skills and eating habits. We assess the child’s sucking, swallowing, chewing patterns, diet, behavior, and the home environment during meal time. Once we pinpoint the underlying problem(s), we create a family treatment plan. Some children require additional one-on-one feeding therapy, and we demonstrate to the parent how to tackle their child’s feeding or eating delay.
Click here to know more about our Infant/ Toddler/ Childhood Feeding Therapy
Literacy Tutoring
For literacy tutoring by our literacy teachers, a non-therapeutic service, we need up-to-date goals. Literacy tutoring performed by our literacy specialists is not eligible for insurance reimbursement.
- Literacy Testing (Language Therapists)
- Literacy Testing (Literacy Specialists)
- Online Literacy Assessment Evaluation
If the literacy intervention cannot be justified by an ICD-10 code (see above), the literacy intervention is considered educational and can be performed by our literacy teachers. New York State believes the ICD-10 code for dyslexia is educational (learning) and not as a Communicative Disorder, e.g. Language Disorder. One day New York State will update their position on dyslexia. Please note that most neuropsychological evaluations do not include decoding and encoding (spelling goals); they mention the need for decoding and encoding intervention. If literacy goals are not included in the neuropsychological evaluation, our first session(s) will include creating these goals. Also, many schools use their methods or commercialized products for creating literacy goals. Unfortunately, some of these tools are not up-to-date with current scientific standards (it's Corporate America ). Fortunately, we use up-to-date assessment tools to reliably identify where your child needs help. Overall, you are in good hands with us, and we will guide you along the way!
If you have up-to-date evaluations/assessments and goals, you can most likely skip reading the rest of this page.
If you are not interested in our intervention services but just need an assessment/evaluation/consultation, we also offer evaluation services!
Phone and Remote Consultations
$150-$200: We offer remote and on-the-phone consultations. Consultations are appropriate when you are not ready for an evaluation/assessment (see below).
TIER 1 EVALUATIONS & ASSESSMENTS (Home, School, English, Multilingual) Performed by Licensed Speech-Language Pathologists/Therapists
English Home Based Evaluations and Assessments:
TIER 1 and TIER 2: $175-$1000 (See below).
English Office-Based Evaluations and Assessments
TIER 1 and TIER 2: $300-$1200 (See below).
Please note that we can rent space throughout NYC to accommodate evaluations and assessments since we are not a brick and mortar company.
Bilingual/Multilingual Assessments TIER1 AND TIER2 Home and Office-Based:
Bilingual/multilingual evaluations are billed at a higher rate than monolingual English evaluations and assessments. Bilingual/multilingual in-home and at-school evaluations/assessments are usually marked up an additional 30 to 50% due to the additional work required to assess more than one language. Office-based bilingual/multilingual evaluations and assessments are an additional cost due to the expenses of renting space.
Speech Language Evaluation includes at least a one-hour in-home or at school visit where we ideally meet you and your child, review previous reports, testing, etc., and within ten business days, a 1.5- to 3-page report with professional impressions, recommendations, and goals (if services are recommended) are produced. This report can be presented to private schools and professionals outside of Manhattan Letters. It cannot be used for IEPs (see TIER2). It helps establish the need for significant but mild articulation and expressive language therapy and for updating current therapy goals.
Articulation/Enunciation/Speech Sounds (ages 3+ only if the individual exhibits difficulties with a few age-appropriate speech sounds): $175-$250
Mildly Delayed Expressive Language (babies-47 months): $200-$300. Three-year-old children with expressive language delays might qualify for a TIER2 evaluation depending on several factors to be discussed by one of our speech pathologists over the phone (free).
Articulation and Expressive Language Concerns: (one visit, babies-47 months) $300-$450. Three-year-old children with moderate to severe expressive language delays will most likely require a TIER2 evaluation depending on several factors to be discussed by one of our speech pathologists over the phone (free).
Social Skills Assessment (18-47-month-old children): $150-$200 We use a standardized empirically validated parent-report questionnaire to help assess pragmatic language development in 18- to 47-month-old children. This assessment helps identify children with delays in pragmatic language development (i.e. the use of language in a broad variety of everyday settings and in interaction with other people) compared to children of the same sex and age in months; to identify children whose expressive language skills should be further evaluated with a comprehensive speech and language assessment. We mail you the questionnaire, you fill it out, mail it back to us and we score it, provide you with the results, and schedule a 30-minute phone consultation.
Codes
We can furnish an ICD-10 code for insurance purposes with a TIER1 Evaluation if the child has articulation difficulties that are not normal for his or her age or if the child has a significant expressive language delay or disorder. We are out-of-network providers and do not accept any third-party payments, but you may be entitled to reimbursement under the out-of-network provisions of your insurance policy.
Please note that a TIER2 Evaluation is recommended for the following circumstances:
When there are significant moderate to severe early language and communication delays (0-36 months).
If the articulation concerns involve more than a few age-appropriate speech sound errors (ages 3+).
If your child is 3 years old and has significant moderate to severe expressive language delays.
If your concerns involve receptive language or literacy (any age).
If your child is greater than four years of age and has delayed language development.
Free Phone Consultation
If you are interested in a private evaluation or assessment, you will speak with a licensed speech-language pathologist on the phone for free to help best determine if your child should be considered for a TIER1 or TIER2 evaluation/assessment.
TIER 2 SPEECH LANGUAGE EVALUATION & ASSESSMENT (Home, School, English, Multilingual) Performed by Licensed Speech-Language Pathologists/Therapists.
$250-$1000* TIER2 Evaluations are more comprehensive than TIER1 Evaluations and include literacy evaluations performed by licensed language therapists. TIER2 evaluations are perfect for private CPSE and CSE evaluations. A TIER2 Evaluation is recommended when a child has more than a few speech sound errors that aren t appropriate for his or her age, and there are significant concerns related to understanding and using oral and written language, particularly when the child is 48 months and older.
- $300-$500 for Moderate to Severe Early Language and Communication Skills (0-36 months)
- $300-$500 for Articulation/Enunciation/Speech Sounds (3 years and up) when the individual is having difficulties with more than a few age-appropriate sounds
- $700-$1000 Apraxia Evaluation performed by Dr. Melissa (see below for more information)
- $300-$500 for Fluency/Stuttering (2 years and up)
- $300-$500 for Early Literacy Skills (4-6 years and up)
- $300-$600 for Literacy (Written Language – Reading and Writing)
- $300-400 for Expressive Language (3 years and up)
- $400-$800 for Expressive and Receptive Language (3 years and up) for students who need their receptive language evaluated and have significant expressive language delays.
- $400-$500 for Expressive Language and Articulation (3 years and up)
- $500-$800 for Expressive and Receptive Language, Articulation (3 years and up)
- $800-$1200 for Expressive and Receptive Language, Literacy, and Articulation (4 years and up)
All of our TIER 2 Evaluations occur over one visit at a quiet space in your home. If you are interested in office space, see below. These visits are 1-3 hours long, and your child will be given breaks. Occasionally, a child is unable to complete the testing with the appropriate amount of time allowed for assessments. We reserve the right to charge an additional $150 fee to schedule a follow-up appointment to complete the testing when these circumstances arise.
TIER2 Evaluations include a 2 to 10-page report (higher costing evaluations result in extended reports and visa versa), including professional impressions, recommendations, and goals. Please allow us up to 10 business days to produce the report. If you need the report in less than ten days, it can be expedited for a fee of $100-$200 depending on how quickly you need the turnaround. For higher costing evaluations ($600 and up), we might require additional time to complete the report (10-15 business days). Results are discussed over the phone or in-person if the data is scored at the time of the assessment. If a parent requests a follow-up meeting to discuss the results in person, this will be billed at the professional s hourly rate.
We can recommend and start intervention before the report is finished because we will know directly after or soon after the evaluation if intervention is warranted and will be able to establish goals. These two essential pieces can be figured out before the report is submitted to you. With your permission, we can share this information with a 3rd party.
ICD-10 codes are furnished if the individual has a significant delay or a disorder. We produce speech and language disorder ICD-10 codes. For an ICD-10 code related to literacy or a learning disorder, e.g., dyslexia, we recommend that you follow up with additional testing performed by a licensed NY State neuropsychologist. We have many great recommendations!
*Office-Based Assessments: Please note that we can rent space throughout NYC for an additional fee. Please note that office-based assessments are billed at higher rates, e.g., $20-40 more per hour to cover our rental expenses.
*Bilingual/Multilingual Assessments: Bilingual/Multilingual evaluations/assessments are usually marked up an additional 30 to 50% due to the additional work required to assess more than one language.
CPT Codes for Speech-Language Pathology
92507: One-on-One Speech-Language Therapy
92508: Group Speech-Language Therapy
92610: (Feeding/Swallow Evaluation)
95: is a modifier for telepractice, and the CPT code, e.g. 92507 or 92508 stays the same. CPT 95 is for reporting telepractice-related services e.g. synchronous telemedicine service rendered via real-time interactive audio and video telecommunication systems.
If insurance asks for a place code it’s (POS) 12 for home-based services and (POS) 11 for office-based services.
Evaluations
92521:Â Evaluation of Speech Fluency
92522:Â Evaluation of Speech Sound Production
92523: Evaluation of Language Expression and Comprehension and Speech Sound Production
92524:Â Behavioral and Qualitative Analysis of Voice and Resonance
ICD-10 Codes
Autism
F84.0:Â Autism Spectrum
Language
F80.1:Â Expressive Language Disorder
F80.2: Mixed Expressive Receptive Language Disorder & Social Communication Disorder
F80.9: Language Disorder/Developmental Disorder of Speech and Language
F80.82:Â Social Pragmatic Communication Disorder
F80.89:Â Other Developmental Disorders of Speech and Language
R48.8: Language Deficits Related to an Organic or Medical Condition. Other Symbolic Dysfunctions, such as Auditory Processing Disorder, cognitive language disorders, and executive function impairment due to organic or neurological conditions.
Learning
315.2Â Unspecified Specific Learning Disorder
F81.0Â Specific Reading Disorder/Specific Learning Disability with Specific Impairment in Reading Comprehension
F81.1 Specific Impairments in Written Expression: Spelling, Clarity and Organization of Written Expression
*Please note that each State defines the definition of Learning Disorders and Language Disorders. The State’s definition might not be in accordance with the definition defined by the American Speech Hearing Association (ASHA).
Speech
F80.0:Â Phonology/Articulation Disorder
R47.1:Â Dysarthria and Anarthria
R48.2:Â Apraxia
*There is no specific code for oral motor related issues
Fluency
F80.81:Â Childhood-Onset Fluency Disorder
Hearing Loss
F80.4:Â Speech and Language Development Delay due to Hearing Loss
Central Auditory Processing Disorder
H93.25 and additional codes
Schedule a Free Consultation Today!
Phone: (347) -394-3485
Text: (917) 426-8880
Email: manhattan@brooklynletters.com
We are ready to help you right now!