Swallowing Therapy Session

This is swallowing therapy: a session with a speech-language pathologist aimed at the muscles and reflexes used to eat and drink safely, rather than at speech. It is ordered when food or liquid is going down badly — or going the wrong way — after a stroke, with a neurological condition, or after treatment for head and neck cancer.

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What it is

Swallowing looks like one action and is actually a fast sequence of them: the mouth manages the food, the tongue moves it back, the airway closes, and the throat squeezes it down. A stroke, a brain injury, Parkinson's disease, or surgery and radiation to the mouth and throat can break any link in that chain. When the airway does not close in time, food and liquid get into the lungs, which is the risk that makes this more than a comfort issue.

The therapy is delivered by the same profession that treats speech, because the structures are the same ones. Sessions combine exercises for the muscles of the lips, tongue, and throat with practised techniques — a particular head position, a deliberate effortful swallow, swallowing twice, alternating solids and sips — and with guidance on which textures and thicknesses a person can manage at the moment. For infants and children the same code covers work on oral function for feeding, which is a different job again: getting a mouth to suck, chew, and accept food.

Why it is done

  • To retrain swallowing after a stroke, which is one of the commonest causes of a sudden swallowing problem
  • To maintain or adapt swallowing in progressive neurological disease, where the goal shifts toward safety and nutrition rather than recovery
  • To rebuild function after surgery or radiation for cancer of the mouth, throat, or voice box
  • To reduce the risk of food and drink entering the airway, and the chest infections that follow
  • To work on feeding and oral skills in infants and young children who cannot manage textures or take enough by mouth

What to expect

A session is usually short and practical. Some of it is exercise without food. Some of it is eating and drinking with the therapist watching closely, trying a technique and seeing whether it changes anything. Recommendations about food texture and drink thickness are often revisited as things change. An instrumental test — a swallow study done with x-ray or with a small camera passed through the nose — may be done separately to see what is happening out of sight; that is a different procedure with its own charge. Family or care staff are frequently taught the same techniques, since most meals happen without a therapist present.

Questions worth asking

  • Is the swallow study that shows what is happening in the throat billed separately from these therapy sessions, and by a different department?
  • In a hospital or skilled nursing facility, is this therapy inside the daily rate or billed as its own line?
  • Thickening products and specialised feeding equipment are often recommended. Are those a pharmacy or supply cost paid separately?
  • If both swallowing therapy and speech therapy are given, are two different codes billed on the same day, and does that count as two visits?
  • Who is providing the therapy — a hospital outpatient department, a rehab facility, or a home health agency — and how does the price differ?

What Swallowing Therapy Session costs by state

Swallowing Therapy Session prices at hospitals

See every published price for Swallowing Therapy Session: the full national range, the state and hospital breakdowns, and which hospitals charge the least.

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Sources

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