Frequently Asked Questions

Most patients describe it as uncomfortable rather than painful. The endoscope is thin and flexible, and passes through the nose in a matter of seconds. The usual sensation is brief pressure or a tickle.

FEES is a low-risk procedure, performed routinely at bedside in hospitals and skilled nursing facilities. There is no radiation and no sedation involved.

The most common effect is nasal discomfort. Serious complications are rare.

We perform FEES exams for patients from the teenage years through older adulthood. Our speech therapy services are for adults.

A FEES exam does not require the patient to follow complex verbal instructions, which means we can evaluate patients others often cannot — including those with advanced dementia or cognitive impairment.

In practice these are often the patients who benefit most, either because transport is difficult or because the goal is safe, comfortable eating rather than full recovery.

As often as is clinically useful. Because there is no radiation, there is no cumulative exposure to limit and no reason to ration exams the way a modified barium swallow study requires.

That matters most for patients whose swallowing changes over time — during a course of radiation, through the progression of a neurological condition, or before and after a tracheostomy change or Passy Muir Valve trial.

We aim to schedule initial appointments within a few days of inquiry for most locations. For urgent clinical needs — particularly for patients at risk of aspiration — please indicate this when you contact us and we will prioritize accordingly.

For facilities with a regular visit schedule, we coordinate timing based on your patient census and clinical urgency.

Families and individuals can contact us directly to inquire about services, no referral needed. Facilities schedule directly with us as well, however we will need a physician's order to see your patients.

Your physician or the facility's attending physician may need to document medical necessity in the patient's chart for internal purposes, but that is separate from our scheduling process.

We currently serve Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont, and hold active speech-language pathology licenses in all six states.

Travel time may affect scheduling availability in more remote areas — please contact us to discuss your location.

Yes. There is no minimum — we will travel for a single patient.

That said, for longer-distance visits where a travel fee applies, seeing several patients in one trip spreads that fee across everyone seen that day, which can bring down the average cost per patient. If you have more than one resident who could benefit, scheduling them together is often the more economical approach.

We provide written dietary recommendations based on what the exam shows, using the International Dysphagia Diet Standardisation Initiative (IDDSI) framework. From there, order entry is handled by the facility through its own process.

We are available to discuss findings directly with the attending physician, nursing staff, or dietitian if that helps move things along.

Findings are reviewed immediately following the procedure, and verbal feedback is provided to nursing staff before we leave. Written reports including dietary recommendations are completed and delivered to the facility within one business day.

Reports include clinical findings, IDDSI dietary recommendations, and a clinical impression.

FEES exams start at $400. The final rate depends on travel distance and how many patients are seen during a single visit — seeing several patients in one trip can lower the average cost per patient.

Speech therapy is priced per session and varies with session length and the type of treatment. Contact us and we will quote your situation directly.

Not at this time. We currently operate on a private-pay basis, billing directly to patients, families, or — in most cases — to the facility or care community that requested services.

We are happy to provide documentation (evaluation reports, treatment notes, FEES reports) that can support insurance reimbursement claims you submit independently, but we do not process insurance claims directly.

For skilled nursing facilities, assisted living communities, and hospitals, we bill directly to the facility on a per-visit basis. We can also establish monthly contract rates for facilities with ongoing, predictable service needs.

Invoices are sent to the facility billing department following each visit or on a monthly schedule, depending on the arrangement. See our For Facilities page for a full overview.

The endoscope undergoes high-level disinfection between every patient, following manufacturer and infection-control standards.

We handle reprocessing ourselves. Your facility does not need to provide reprocessing equipment, sterile processing support, or storage. Documentation of our protocol is available on request for your infection control committee.

Very little. From you we need access to the patient, a chair or bed where they can be positioned upright, adequate lighting, food and drink trials, and enough chart access to review relevant medical history. A staff member familiar with the patient is helpful but not required.

We arrive with the portable endoscopy tower, scope, light source, recording equipment, and all reprocessing supplies. For therapy visits we bring standardized assessment tools and therapy materials.

It depends on what you need. Most often we serve as a diagnostic resource: your SLP identifies a patient who needs instrumental swallowing assessment, we perform the FEES and provide the findings, and your SLP carries out treatment from there. We are not there to take over their caseload.

For facilities that need additional treatment capacity — coverage gaps, census spikes, or cases outside a clinician's comfort zone — we can also provide ongoing therapy. We will work out the arrangement that fits.