When teletherapy took off during COVID-19, most SLPs grabbed whatever video tool was available. Zoom, Google Meet, FaceTime — the goal was just to keep seeing clients. A lot of practices are still running on those same tools today. And while that worked as a temporary fix, it's worth asking: is what you're using actually built for speech therapy?
Finding the right teletherapy software for speech therapists isn't just about picking a video platform with a HIPAA checkbox. It's about finding something that supports how speech therapy actually works, connects to your documentation and billing, and won't leave you juggling three separate systems after every session. As of January 1, 2026, SLP telehealth is now permanently authorized under Medicare through 2027,1 which means teletherapy isn't a workaround anymore. It's a service line worth building the right infrastructure around.
Here's what to look for, and what to skip.
There's an important distinction worth making early: HIPAA-compliant video conferencing is not the same thing as speech therapy software built for clinical delivery. One handles the call. The other handles the therapy.
At the baseline, any platform you use needs encrypted video with a signed Business Associate Agreement (BAA), reliable high-quality audio (latency and distortion affect what you hear a client produce, and that matters in speech therapy), screen sharing, and a client-facing setup simple enough that families don't spend the first 10 minutes troubleshooting a download.
But that's just the floor. What separates purpose-built online speech therapy software from a generic video tool is the clinical layer on top: shared annotation and whiteboard tools so you can circle phonemes on a PDF, highlight target words, or draw placement diagrams together. A digital material library with articulation cards, minimal pairs, and language activity worksheets. Interactive tools that keep pediatric clients engaged — visual timers, turn-taking games, reward boards.
Think about what a session actually looks like. Say you're working with a 6-year-old on /s/ clusters. In person, you'd pull out picture cards, point to the stimulus item, and mark accuracy in your note. Via teletherapy, you need a shared screen, a way to annotate together, and session notes accessible from the same system. If any one of those pieces lives in a different app, you're context-switching mid-session instead of focusing on the kid in front of you.
Client-side friction is worth considering too. Platforms that require a software download create setup barriers that lead to late starts and early dropout, especially in pediatric caseloads where parents are managing the session setup on behalf of a 5-year-old.
Every teletherapy platform claims to be HIPAA compliant. Most SLPs can't explain what that actually means, or verify whether the platform they're using qualifies.
The most important document in the equation is the Business Associate Agreement, or BAA. It's a contract between you and your software vendor that establishes the vendor's legal responsibility to protect your patients' health information. Under HIPAA, every vendor that handles protected health information must sign one.2 Consumer platforms like Zoom's free tier, FaceTime, and standard Google Meet don't provide BAAs. If you can't produce a signed BAA for your video platform, you're technically not compliant, regardless of what settings you've toggled.
Beyond the BAA, HIPAA compliant teletherapy requires end-to-end or in-transit encrypted video, secure storage of session data and recordings, role-based access controls so clients can only access their own records, and an audit trail showing who accessed what and when.
Here's a scenario that's more common than most people acknowledge: an SLP switched on Zoom's "HIPAA-compliant settings" when she started seeing clients remotely. She didn't realize that actual HIPAA compliance on Zoom requires a paid account and a separately executed BAA — neither of which she had set up. After 18 months of sessions, she'd been out of compliance the entire time. This isn't a trap unique to any one platform. It's a trap that comes from trusting a checkbox over a contract.
Two red flags to watch for when evaluating any option: a vendor that claims HIPAA compliance but can't produce a BAA on request, and a platform that retains session recordings indefinitely without consent controls baked in.
Here's news that hasn't made it into most SLP workflows yet: as of January 1, 2026, all SLP and audiology telehealth services are permanently authorized under Medicare through December 31, 2027.1 The years of short-term extensions are over. You can build a teletherapy service line without waiting each year to see if Congress renews it.
There's also a billing change that's catching practices off guard. Starting January 1, 2024, Medicare stopped accepting modifier 95 for telehealth claims. You should now use Place of Service code 10 when the patient is in their home, or POS 02 when they're at another location.3 Claims going out with the old modifier risk being flagged or denied.
A common scenario: an SLP updated her documentation workflow at the start of 2024 but forgot to update her billing template. Three months of telehealth claims went out with modifier 95 instead of POS 10. She caught it during an audit prep review and had to refile. It's exactly the kind of error that a speech therapy EMR with integrated billing prevents, because the place of service code gets set once in the system and applies correctly to every claim going forward.
The 2026 Medicare fee schedule also includes a modest 2.5% payment increase,4 though CMS adjustments partially offset the gains depending on the service code. ASHA's 2026 Medicare Fee Schedule for SLPs has the specifics worth bookmarking.
If your teletherapy platform isn't connected to your billing system, every policy change means updating two separate workflows and hoping they stay in sync. That's the real cost of fragmented tools.
There are two broad approaches to choosing a speech therapy telehealth platform, and neither is always right.
Standalone teletherapy tools like Blink Session, Coviu, and Ambiki are designed to make the session itself excellent. They invest in interactive materials, video quality, and pediatric engagement features. If you have an established EMR you're not leaving and it just doesn't support remote delivery well, a standalone tool might fill that gap without requiring you to migrate everything.
Integrated private practice software that combines teletherapy with scheduling, documentation, billing, and a patient portal in one system offers a different trade-off. Your session, your note, and your claim all live in the same place. Goals don't need to be re-entered across platforms. The appointment reminder that goes out before the session is the same system tracking whether you've completed the documentation afterward.
The hidden cost of running on three separate platforms isn't just the subscription fees, though those add up. It's the 30 to 40 minutes after each session spent manually reconciling information. It's the billing errors that come from re-entering CPT codes by hand. It's the cognitive overhead of separate logins, separate update cycles, and separate support contacts when something breaks.
A practical question to ask any vendor before you sign: how many logins does a complete teletherapy session require, from scheduling to completed therapy notes to submitted claim? If the answer is more than two, you're paying for complexity you probably don't need.
Most content about teletherapy focuses on private practice. But university training clinics face a genuinely different challenge, and it almost never comes up.
When students deliver teletherapy, the supervision model has to live in the software. ASHA requires direct supervision for at least 25% of a student's clinical contact hours,5 and supervisors must review and co-sign all documentation before it becomes part of the clinical record. That workflow can't rely on email chains or printed drafts passed between offices. It needs to happen inside the system.
Student access controls are also non-negotiable. Under HIPAA, student clinicians should only see the records of their assigned caseload, not the full clinic database. Role-based permissions aren't a preference — they're a compliance requirement.
Then there's the semester turnover problem. A new cohort of graduate students arrives every term. If the software takes weeks to learn, you're burning clinical hours on training at the start of every semester, every year.
Here's what a well-designed university teletherapy workflow actually looks like: a second-year grad student delivers a session for a preschooler with a phonological disorder. After the session, she submits her SOAP note draft in the system. Her clinical supervisor reviews it, adds feedback directly in the record ("document the specific cue level, not just 'minimal cues'"), and the student revises. The supervisor co-signs the finalized note. No email thread. No printed draft. No version confusion. The record is clean, compliant, and complete.
That's not an aspirational workflow. It should be the standard one. When students are delivering care remotely, the supervision model has to live in the software — because if it doesn't, the supervisor is flying blind.
Before you commit to any teletherapy software for speech therapists, three questions are worth asking: Does it provide a signed BAA? Does it integrate with your EMR and billing, or does it require a separate documentation system? And does it include tools built specifically for speech therapy sessions, not just a shared screen?
Looking for an integrated solution for your speech therapy practice or university clinic? ClinicNote combines scheduling, SOAP note documentation, billing, and telehealth support in one system — built for how speech-language pathologists actually work, with 117 speech clinics already on the platform. See how it works for private practice or learn about university clinic features.