The pricing of speech therapy assessments is based on a system of AMO coefficients that most articles summarize as an “average price” without distinguishing the different labels in the nomenclature. Here, we detail the price of a speech therapy assessment in France based on the type of procedure, recent developments in the nomenclature, and the reimbursement mechanisms that determine the actual out-of-pocket costs.
AMO Coefficients and Fine Segmentation of Speech Therapy Rates
Each assessment corresponds to a multiplier coefficient that directly determines the agreed rate. An assessment of communication and oral or written language is rated AMO 34, which is 88.40 euros. An assessment for neurological disorders is rated AMO 40, which is 104 euros.
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This segmentation is not trivial. Depending on the reason for the prescription, the price of a speech therapy assessment in France can vary from simple to double.
| Type of Assessment | AMO Coefficient | Agreed Rate |
|---|---|---|
| Swallowing and Eustachian tube functions | 26 | 67.60 € |
| Phonation | 34 | 88.40 € |
| Oro-myo-facial functions and oral skills | 34 | 88.40 € |
| Communication and oral/written language | 34 | 88.40 € |
| Mathematical cognition | 34 | 88.40 € |
| Neurological disorders | 40 | 104.00 € |
| Stuttering and fluency disorders | 40 | 104.00 € |
| Motor, sensory disabilities, ASD, deafness | 40 | 104.00 € |
| Prevention assessment (without rehabilitation) | 20 | 52.00 € |
The renewal of an assessment, which concerns all patients under prolonged follow-up, is billed at a lower rate than that of the initial assessment.
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Prevention Assessment (BPA) vs. Diagnostic Assessment: Two Procedures, Two Prices
Since 2023, the distinction between the first attention assessment (BPA) and the complete diagnostic assessment has been clarified in professional practice. The BPA is a short early detection procedure, rated AMO 20 (52 euros), which does not lead to a rehabilitation plan. It is used to guide the patient or reassure the family.
The diagnostic assessment, on the other hand, engages the speech therapist in a complete protocol with standardized tests, writing a structured report, and, if necessary, proposing a therapeutic project. The difference in rates reflects a real gap in clinical time and professional responsibility.
We observe that many parents request a “speech therapy assessment” without knowing that they may first be offered a BPA. The BPA costs nearly 40% less than a standard diagnostic assessment, but it does not allow for the initiation of a reimbursed rehabilitation pathway.
Social Security Reimbursement and Out-of-Pocket Costs with Health Insurance
Health insurance reimburses speech therapy assessments at 60% of the agreed rate, provided that the procedure has been prescribed by a doctor. Contracted speech therapists do not charge excess fees: the applicable rate is the actual rate.
For a language assessment at 88.40 euros, Social Security covers 53.04 euros (60%). The patient is responsible for the remaining 35.36 euros, plus a flat fee of 1 euro per procedure.
- Patient without insurance: out-of-pocket cost of about 36.36 euros for an AMO 34 assessment
- Patient with responsible insurance: the out-of-pocket cost is fully covered, only the 1 euro deductible remains
- Patient in ALD or CMU-C: 100% coverage, no deductible
For neurological assessments or those related to the autism spectrum (AMO 40, 104 euros), the out-of-pocket cost without insurance reaches about 42.60 euros. Health insurance then becomes a significant financial lever, especially for families engaged in a long care pathway.
Special Case of Rehabilitation Sessions Post-Assessment
The assessment is just the entry point. The subsequent rehabilitation sessions are billed according to their own AMO scale, with lower coefficients. Over a follow-up of thirty sessions, the cumulative out-of-pocket cost without supplementary insurance can reach several hundred euros. We recommend checking the “medical auxiliaries” coverage level of your contract before starting a speech therapy pathway.
Expansion of Speech Therapy Scope and Impact on Pricing Nomenclature
The official extension of the speech therapists’ scope of practice, established in 2019, has included areas such as neurodevelopmental disorders and acquired cognitive disorders. This evolution explains the multiplication of assessment labels in the current nomenclature and the pricing gap between a “classic” language assessment and a specialized assessment.
Assessments related to motor and sensory disabilities, autism spectrum disorders, or genetic diseases are rated AMO 40 because they require specific skills, adapted assessment tools, and longer clinical time. Reducing the price of a speech therapy assessment to a single range ignores this pricing complexity.
A prescribing doctor who specifies the reason for the assessment on the prescription allows the speech therapist to bill the procedure at the correct coefficient. A vague prescription can lead to underbilling and, consequently, a reimbursement lower than what the clinical situation justifies. This administrative detail has direct consequences on the billed rate and the amount reimbursed.