Medical Necessity Criteria For Speech Therapy

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Medical Necessity for Audiology and Speech-Language …

https://www.asha.org/practice/reimbursement/medical-necessity-for-audiology-and-SLP-services/

Relevant documentation for establishing medical necessity may include the following: 1. Medical history:Pertinent medical history that influences the speech, language, and hearing treatment, brief description of functional status, and relevant prior treatment. 2. Speech, language, hearing, … See more

Medicaid Toolkit: Medical Necessity - American Speech …

https://www.asha.org/practice/reimbursement/medicaid/medicaid-toolkit-medical-necessity/

Although each state establishes a state plan, including specific requirements, relevant documentation for establishing medical necessity may include: medical history, such as …

Medical Necessity Guidelines: Rehabilitative …

https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/rehab-services-st

• For rehabilitative speech therapy, the Member must have a diagnosis of a speech, hearing or language disorder resulting from injury, trauma or a medically based …

Speech Therapy - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/200_299/0243.html

Documentation Requirements The plan of care should include sufficient information to determine the medical necessity of treatment. The plan of care... The plan of care must …

Speech Therapy - Cigna

https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0177_coveragepositioncriteria_speech_therapy.pdf

• The medical necessity of the therapy has been demonstrated by results of testing with a videofluorographic swallowing study (VFSS) or other appropriate testing in …

CG-REHAB-10 Site of Care: Outpatient Physical Therapy …

https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_c196852.html

The individual's medical status requires enhanced monitoring beyond what would routinely be needed for physical therapy, occupational therapy or speech …

Speech Therapy (speech) - Medi-Cal

https://files.medi-cal.ca.gov/pubsdoco/publications/masters-mtp/Part2/speech.pdf

The Medi-Cal program definition of medical necessity limits health care services to those necessary to protect life, to prevent significant illness or significant disability, or to …

LCD - Speech - Language Pathology (SLP) Services: …

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=35070

The speech-language pathology services discussed in this LCD are those evaluation and therapeutic services necessary for the diagnosis and treatment of speech …

Guidelines for Medical Necessity Determination for …

https://www.mass.gov/doc/speech-and-language-therapy/download

Documentation of medical necessity must include all of the following: The primary diagnosis name and ICD-CM code for which treatment is being requested; The …

Medical Necessity Criteria and Clinical Review Guidelines

https://www.medmutual.com/For-Providers/Medical-Necessity-Criteria-and-Clinical-Review-Guidelines

Medical Necessity Criteria and Clinical Review Guidelines Care Management uses nationally recognized and accepted utilization management criteria, as well as internally …

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