Vision is not claimable. Hearing could be claimable if it is provided by a licensed audiologist and the service is listed on the IEP.
Covered Speech and Language Pathology, Audiology, and Hearing Services SLP, audiology, and hearing services are covered for children with speech, language, or hearing disorders that adversely affect the child's functioning. The following services are covered if identified in the child's IEP:
- Evaluation and re-evaluation to determine the child's need for SLP, audiology, and/or hearing services (if the service results in the development or revision of an IEP); recommendations for a course of treatment; and providing direct treatment interventions.
- Individual therapy/treatment or group therapy/treatment in groups of two to seven children.
- Medical equipment identified in the IEP intended for only one child for use at school and home.
Speech and Language Pathology, Audiology, and Hearing Services Provided Under Supervision The CMS requires certain guidelines to be met for federal reimbursement of services that are provided under the direction of a qualified speech-language pathologist or audiologist. To ensure funding, school districts and CESAs are required to comply with the federal guidelines.
SBS provided under the direction or supervision of a speech-language pathologist or audiologist must meet the following requirements:
- A supervising speech-language pathologist or audiologist must meet Medicaid's specific licensing and enrollment requirements.
- The supervising speech-language pathologist or audiologist must see each member at the beginning of and periodically during treatment, be familiar with the treatment plan, have continued involvement in the care provided, and review the need for continued services throughout treatment.
- The supervising speech-language pathologist or audiologist must assume professional responsibility for the services provided under his or her direction.
- The supervising speech-language pathologist or audiologist must ensure that the individual working under his or her direction can contact him or her as necessary during the course of treatment.
- A supervising speech-language pathologist or audiologist may not supervise more service providers than is reasonable, ethical, and in keeping with professional practice in order to permit the supervising speech-language pathologist or audiologist to adequately fulfill his or her supervisory obligations and to ensure quality care.
- The entity employing the supervisory speech-language pathologist or audiologist is responsible for ensuring that these standards are met.
- The employing entity is responsible for ensuring that appropriate documentation is maintained to prove that the above requirements were met. The employing entity is also responsible for ensuring that there is appropriate documentation of services provided by the supervising speech-language pathologist or audiologist and by the individuals working under the direction of the supervising speech-language pathologist or audiologist.
Speech and Language Pathology Provider Qualifications Medicaid reimbursement is available for SLP services only if provided by or under the direction of a practitioner who has completed the educational requirements and the work experience necessary for the ASHA certificate, and has passed the PRAXIS exam in SLP.