Ok I know rates are the one thing nobody wants to talk about here, but I’d rater ask and feel a little awkward than get lowballed. So, taboo acknowledged, go easy on me lol.

A SNF reached out to me directly about doing contract speech therapy, no agency involved, straight up 1099/independent contractor. I’m in early in talks with them.

Some stuff working against me:

• no guaranteed minimum hours
• 30 to 45 min drive each way
• they’ll do federal mileage rate reimbursement but that’s it so far

im trying to figure out:

1. If you’ve contracted directly with a SNF (not through a staffing agency), what hourly or day rate did you actually negotiate?
2. Did you do straight hourly, a day rate, or hourly with some kind of minimum built in to cover travel/no shows?
3. Is mileage reimbursement enough on its own, or did you also get them to pay separately for drive time?

Basically, I’m trying not to end up in the situation where I drive 40 min, get there, and the patient’s at an appointment or refuses, and I just ate the whole day for nothing.

If you’d rather not post numbers publicly, feel free to DM me instead, totally get it. Any advice, contract language, or “wish I’d asked for X” hindsight appreciated.

Anyone in this sub work as an oral myofunctional therapist for a dental practice or work in a medical practice doing photobiomodulation? I’m looking to make a pivot from running my own business and trying to see if this scenario even exists. Thanks!

Has anyone started a private practice with the intention to only complete evals?

I’ve had my CCCs for about 4 years and have primarily worked in Peds both in the schools or in other private practices. I’ve realized that, while treatment can be fulfilling, I much prefer the idea of solely facilitating evaluations and then sending kids on their way to get services with another clinic.

If anyone knows anything about this business model or has some experience, I’d appreciate it!

My spla has been driving me crazy since starting. If it’s not one thing it’s another. I’ve tried everything to help the situation however I’m just at a loss.

( I’m the supervising Slp )

If yall have any horror stories and what helped yall that would be great

I recently applied to a position where I did one of my clinical rotations as a grad student (job #1). I accepted the offer and was supposed to start within 2 weeks. I never signed the employee agreement. Cancellations aren’t paid and it’s a per billable rate model.

A week before my start date, I stumbled upon another opportunity at a newer clinic (job #2). They offered me significantly more per billable hr, paid indirect time, and paid cancellations I would also have close mentorship and work closely with the owner who is also an SLP. Not only financially but for future career development- this position felt more aligned.

I ultimately ended up withdrawing my acceptance from job #1. As a result they let me know that I am now “not re-hireable” as they had already told patients I would be seeing them.

I understand the inconvenience and frustration. But I’m really bummed by their response since I truly loved the relationships and experience there as a student. I also feel awful that I disappointed some people that I really admire.

I know it probably comes from a place of care, but I have now had two separate families I work with ask if I also babysit, and would be willing to babysit their kids (just this week!). Who else has had this experience? It just feels like I am not always seen as a professional. I will get out of my own feelings and be okay, just looking for some validation.

As a part of my ongoing efforts to understand and compare the new CPT codes I decided to make this chart comparing a clinic's revenue with the upcoming changes. The boxes are color-coded by revenue (more revenue for darker green and less for lighter green). Though I've only seen clinics do 25 60-minute appointments & 50 30-minute appointments I wanted to see what a caseload that brought in the same revenue as the OTs & PTs at my last clinic would have been like for 30-minute & 45-minute appointments. I thought I'd include a new caseload that would equal the current revenue for 50 30-minute appointments, too. To me that shows how the SLPs currently carrying the 50 30-minute caseloads aren't getting enough time for prep & documentation (especially if 1.3 RVU for 92507 is accurate).

I added the second chart to show that with the new CPT codes only the Speech & Language code carries an RVU of 2.0/hour - the others are all slightly less so it will still be hard for us SLPs to achieve 2.0 RVU/hour and I'm curious how hard that is for OTs & PTs and how much "wiggle room" administrators are giving their clinicians.

Just a quick note to add that these reimbursement rates are based on my last clinic's rate, but they're not too far above to the rates I have with my insurance contracts now. Right now I do 45-minute appointments & one of my insurance companies pays me $70 for 92507 (and also 92523 & 92522, which is depressing and I'm hoping these changes will force them to respond to my attempts to renegotiate my contract), 4 that pay me $100 for 92507 & 1 that pays me $120 for 92507. I'm hoping with these new codes I can renegotiate rates that are proportional to the codes' RVUs (which would be slightly increased revenue for most of the codes). 🤞

Hi all! I’m a 5th year SLP who spent the last 5 years in the school setting and just transitioned full time to a SNF. I want to make the effort to get better at my job because I feel like a fish out of water! My commute is 45 minutes to an hour, I work nonstop for 8 hours, barely have a 15 min lunch (which sometimes I skip), and then have an hour drive back home. I feel totally depleted by the end of the day Monday-Friday. Do I just take some time to study on the weekends? How does everyone do it for those who transitioned from school to medical? Thanks for any and all advice!

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hi! I’m currently looking for a CF and I’m torn between a middle school placement and an SNF. i really liked my SNF experience but I also feel like middle school would burn me out less since SNFs can be a bit depressing and emphasize productivity so much. has anyone had experience doing a CF in one area and switching to another for their full time position? I won’t feel as bad either way making a choice if it’s not impossible to switch after… i just don’t know which to do!

Thoughts on applying for maternity leave positions as a CFY? Am I able to finish my cf after completing a leave position?

So long story short, I had a baby in April and went out on leave. I signed my contract for this year in May. I have been there since Feb 2025. Lo and behold a dream part-time position came up a week and a half ago. It’s an old supervisor of mine that reached out to me trying to fill the position. (20/hours guaranteed a week in an early intervention program housed in a special needs school, specialist/consultant type role for AAC and feeding, no IEPs!, paid for paperwork, can make the hours whatever I want) Since this can work me financially, I love the flexibility and the opportunity to stay home with my baby more. I just hate giving a notice after telling everyone I’m coming back and being so sure of it. I’m honestly not even sure how to go about resigning when it’s still summer and there are so many people involved (principal, EC director, lead SLP, EC chair).
Any advice?

I have a job offer for a school CF position in Louisiana at $50,000. I was told there isn’t room to negotiate pay with the district. This pay seems really low for a Masters degree but I really want to work in the school system. Is this really how low pay is in Louisiana? Will it go up significantly once I get my C’s?

I am nervous, this is my third year and the first time in a middle school!! What are the key differences between elementary v. Middle school in terms of student behavior, therapy sessions, frequency etc. ??

State is Connecticut.

I moved and no longer had access to my precious email address aka I missed notifications to renew my state licensure. I don’t blame anyone but my self and am already feeling really guilty and horrible. I have worked in a school and clearly no one else noticed. It has not been active for 10 months. Im not working now because summer. I completed the reinstatement licensure online and am planning to call the state tomorrow and see if there is anything else I need to do. I also start a new job in 6 weeks so I really need it reinstated by then.

my mind is spiraling that I’m going to get my license revoked and not be able to work again. anyone have experience with this?

Hi!

So my facility is having an issue properly following diet texture recommendations. In the past I’d seen people put signs on the walls or a whiteboard in someone’s room with diet orders, transfer info, etc. I want to do this in our facility to help staff remember things, but they are hesitant saying it’s a HIPAA violation because patients share rooms.

I don’t understand how other facilities do this and think if it is IN THEIR ROOM and doesn’t have their name on it, how it could be a violation.

Do any of your facilities or hospitals do this?

Wanting some backup!

Edit: no need for *dirt recommendations lollll

I run a community group for toddlers and parents and would like to have a good AAC or core board blown up/laminated to use in the class. We aren’t always in the same room/center so I need to be able to take it with me. Any recommendations? The ages are birth to 5/6.