Opening a Speech Therapy Telepractice: What You Need to Know

From improved access to care to more flexible scheduling, telepractice (speech-language pathology services delivered remotely using telecommunication technology, including real-time video) can offer meaningful benefits for clinicians and the people they serve. ASHA uses the term telepractice rather than “telemedicine” or “telehealth” to avoid the misconception that remote services occur only in medical settings.

Telepractice expanded rapidly during the COVID-19 public health emergency, but it did not disappear when the emergency ended. The federal COVID-19 Public Health Emergency (PHE) ended May 11, 2023, and many temporary flexibilities transitioned into a mix of permanent updates, time-limited extensions, and state-by-state rules.

For a deeper, research-informed look at how telepractice is evolving, including asynchronous telepractice models review ASHA Introduction to the SIG 18 Forum: Asynchronous Telepractice in Audiology and Speech-Language Pathology.

The content on this page is intended for informational purposes only.

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Why Provide Speech Therapy via Telepractice?

While many SLP career options involve working in schools, care facilities, and other settings, you don’t always have to treat patients in person. For clinicians, telepractice may expand your reach to people who live farther away or in areas with limited access to SLP services.

Telepractice can also reduce overhead costs compared with a traditional brick-and-mortar practice (for example, by reducing the need for dedicated office space). That can improve your take-home income, helping more of your SLP salary stay with you rather than going to fixed business costs. At the same time, telepractice comes with compliance “rules of the road” that can affect where you can serve clients and how you get paid:

Licensure and location rules: Telepractice requirements and enforcement are still largely state-based, and the client’s location during the session often matters.
Payer policy: Coverage varies by payer. Medicare telehealth policy, in particular, has evolved following COVID-19.
Time-limited federal flexibilities: According to the Centers for Medicare & Medicaid Services (CMS), some Medicare telehealth flexibilities are authorized only for a defined period, with changes anticipated thereafter.

In other words, telepractice is here to stay, but the practical details depend less on emergency COVID policies and more on ongoing state requirements and payer coverage decisions.

Speech Therapist Telepractice Qualifications

When it comes to opening a telepractice, it is just like opening a brick-and-mortar practice. You still need SLP certification, among other things. Here’s the full list of requirements:

A master’s degree in speech-language pathology
400 hours of supervised clinical practicum experience
A Clinical Fellowship (minimum 36 weeks and 1,260 hours)(at least 36 weeks long)
Completion of the Praxis exam in speech-language pathology
The American Speech-Language-Hearing Association (ASHA) Certificate of Clinical Competence for Speech-Language Pathologists (CCC-SLP)
State licensure (required to practice; rules vary by state and setting)
Meeting any telehealth/telepractice-specific rules for your state license, and for the state where your client is located during sessions

6 Steps to Start Your SLP Telepractice

Because telepractice is shaped by privacy/security, licensure, and payer rules, it helps to follow a simple setup checklist. These steps summarize the core areas you’ll want in place before seeing clients online.

Step 1: Confirm compliance and where you’re allowed to practice. Before you see your first client, verify the licensure and telepractice rules that apply, especially because requirements are largely state-based, and the client’s location during the session often matters.
Step 2: Choose secure technology and set up your basic workflow. Select a video platform and decide how you’ll handle scheduling, session security, documentation, and backups so sessions run smoothly and consistently.
Step 3: Build (or adapt) telepractice-ready therapy materials. Gather digital activities and tools you can use over screen share, and set up a simple system for sharing home practice and tracking progress.
Step 4: Create a client onboarding process. Prepare clear, repeatable instructions for clients/caregivers so they know how to join sessions, which devices/settings work best, and what to do if tech issues arise.
Step 5: Plan how you’ll get paid and what you’ll bill. Confirm telepractice coverage and billing rules with payers (and/or set clear private-pay policies), because coverage varies widely by payer and state.
Step 6: Market your telepractice and build referrals. Set up an online presence that helps clients find you, understand what you offer, and take the next step, while also building a referral pipeline.

Step 1: Confirm Compliance and Where You’re Allowed to Practice

Before you see your first client, confirm the licensure and telepractice rules that apply to your services, especially because telepractice requirements are largely state-based, and the client’s physical location during the session often determines what rules you must follow. A good starting point is ASHA’s Telepractice Practice Portal, which outlines key considerations for telepractice service delivery, including compliance, privacy, and reimbursement:

If you plan to see clients across state lines, also review the Audiology & Speech-Language Pathology Interstate Compact (ASLP-IC). The compact may allow eligible clinicians to practice in other member states through a compact privilege, but eligibility and participating states vary, so it’s important to verify whether the states you’re working with are members and what requirements apply:

What to do in this step:

Review ASHA’s Telepractice Practice Portal and note the compliance issues you must address before launching:
Confirm where you’re allowed to practice by checking the rules for:
- The state where you hold a license, and
- The state where your client will be located during sessions (if different).
If you’ll serve clients in multiple states, check ASLP-IC status and requirements for your situation:
- Are the states involved compact member states?
- Do you qualify for a compact privilege, or do you need additional licensure?
Document your “service area” policy (where you will/won’t see clients via telepractice) so you can screen new clients consistently and avoid compliance surprises.

Step 2: Choose Secure Technology And Set Up Your Basic Workflow

Once you know where you can legally practice, the next step is to choose technology that supports privacy and reliability, and then build a basic workflow so sessions run consistently.

If you’re subject to HIPAA, use vendors that comply with HIPAA rules and will enter into Business Associate Agreements (BAAs) when required. Review ASHA’s guidance on AI to understand how artificial intelligence fits into your workflows in a compliant way.

From there, choose a video platform with the core features you’ll rely on (video, screen sharing, and interactive tools), and create a plan for scheduling, documentation, and contingency plans for when technology fails. HHS’s telehealth guidance is a useful checklist-style reference for building policies and procedures:

What to do in this step

Choose a video platform that supports secure sessions and your therapy workflow (screen sharing, stable audio/video, usability).
If HIPAA applies, confirm vendor compliance and whether a BAA is available:
Set your workflow basics:
- scheduling + reminders
- session security (passwords/waiting room)
- documentation timing + storage
- backup plan if video drops (alternate link, phone, reschedule)

Step 3: Build (Or Adapt) Telepractice-Ready Therapy Materials

Telepractice works best when your materials are designed for screen sharing and remote participation. ASHA frames telepractice as a service delivery model that should be delivered in a way that maintains quality and follows professional guidelines and applicable laws—so your materials and procedures should support that standard:

If you’re conducting speech/language/cognitive assessments via telepractice, ASHA also provides assessment-specific considerations (including how remote delivery may require modifications and documentation of those modifications):

What to do in this step

Build a digital “therapy library” you can easily share on screen (activities, visuals, worksheets, games, prompts).
Create a simple way to deliver home practice (PDF handouts, email templates, portal uploads) and track what was assigned.

For telepractice assessments, plan how you’ll preserve standardization when possible and document any necessary adaptations.

Step 4: Create A Client Onboarding Process

Even tech-comfortable clients do better when they know exactly what to expect. A simple onboarding process improves session quality, reduces troubleshooting time, and supports privacy/security habits (like using the right device, being in a private space, and understanding how you’ll communicate). HHS shares best practices that can help you structure onboarding around consent, policies, and secure communication practices:

What to do in this step

Create a repeatable “First Session Checklist” (device, internet, space, headphones, caregiver role if applicable).
Send login instructions in advance (including links, passwords, any required downloads, and instructions for what to do if disconnected).
Decide how you’ll handle consent and privacy expectations as part of intake/onboarding
Build a quick troubleshooting plan you can reuse (an email template and a short script for calls/texts if the session fails).

Step 5: Reimbursements from Telepractice Clients

Telepractice reimbursement varies by payer and state, so it’s important to confirm coverage and billing rules before you begin providing services. ASHA’s telepractice reimbursement guidance is a strong anchor source here and explicitly recommends verifying payer policies (including which services/codes/modifiers are accepted):

For Medicare-specific planning, ASHA provides SLP-focused guidance on current rules and updates (including authority/coverage timelines) and links to Medicare documentation requirements:

And for official Medicare telehealth coverage/billing background, CMS maintains a telehealth hub with updates and FAQs:

What to do in this step:

Decide whether you’ll be insurance-based, private pay, or hybrid—and document your policies.
Verify payer rules before you treat:
- whether telepractice is covered
- eligible provider types
- eligible CPT codes
- required modifiers/place of service codes
If billing Medicare, use ASHA’s Medicare telehealth guidance to confirm current rules and documentation requirements.
Use CMS’s telehealth hub for Medicare coverage/billing updates and FAQs.

Step 6: Market Your Speech Language Pathology Telepractice Online

Once your compliance, systems, onboarding, and payment plan are set, marketing becomes much simpler—because you can clearly communicate what you offer, who you serve, and how clients can get started. ASHA’s Practice Portal includes private-practice support and discovery tools (including ProFind) that can help patients find ASHA-certified providers:

What to do in this step:

Build a clear, client-friendly website (services, age groups, specialties, location/telepractice service area, how to book/contact).
Add a frictionless “next step” (e.g., an online booking link, a contact form, or a call/email CTA).
Consider provider directories and profiles where your ideal clients already search (and keep your info consistent everywhere).
Develop a referral loop:
- ask happy clients for referrals (and make it easy—shareable link, email signature)
- introduce yourself to local professionals (pediatricians, schools, counselors, OTs/PTs) with a one-paragraph referral guide

If relevant to your practice, consider ASHA ProFind to improve discoverability:

Is a Speech Pathologist Telepractice Right for You?

Now that you know the basics for opening an SLP telepractice, one question remains: Is this the right path for you? Before deciding, you’ll want to do a thorough risk assessment.

Running your own practice can be riskier than working for an employer, because your income depends on factors you control, such as marketing, client retention, scheduling, and the consistency of referrals. On the other hand, telepractice may have lower overhead than a traditional brick-and-mortar practice, since you may not need to rent or maintain a dedicated office space. And if you build a steady caseload, telepractice can offer strong earning potential, sometimes higher than that of a salaried role or a small in-person practice.

Telepractice can also offer flexibility. For example, if your caseload is still growing, you might work part-time in another setting while building your telepractice on the side. If demand picks up and your schedule stays full, you can always transition into telepractice full-time.

In the end, only you can decide if the benefits outweigh the risks and if you can make telepractice work for you.

Information last updated: April 2026

Sponsored online speech pathology programs

Master’s in SLP: Study Online Full or Part Time

Speech@Emerson enables you to earn an MS online and pursue SLP certification in as few as 20 mos. Learn the same curriculum as the on-campus program. Study FT or PT.

Aspiring SLP generalists are prepared to pursue ASHA certification.
Students can earn an Emerson Master of Science in Communication Disorders online in as few as 20 months.
Online classes are taught by expert Emerson faculty—most of whom are practicing SLPs who view students as colleagues and collaborators.

info AD

Online MS in Speech-Language Pathology from Pepperdine University

Full-time (five trimesters) or part-time (eight trimesters) options available.
No GRE scores required.
400+ supervised, clinical learning hours are done at schools/clinics local to students
Three onsite experiences build a sense of camaraderie and community throughout the program

info AD

Want to Become an SLP? Earn an MS Online at NYU

NYU Steinhardt’s online master of science program in Communicative Sciences and Disorders prepares aspiring speech-language pathologists with a comprehensive professional education.

Prepares students to pursue SLP licensure
Accredited by ASHA’s Council on Academic Accreditation
As few as six terms to complete
Full-time and part-time plans of study

info AD