SHPBN-2016-073 Services Billable by Speech Therapists
Date: 10/17/16
Effective January 1, 2016
Effective September 19, 2016, retroactive to dates of service on or after January 1, 2016, independently enrolled licensed or certified Speech Therapists and Speech and Language Pathologists (ST/SLP) may perform and bill KMAP for speech therapy related services (see code list below). ST/SLP may only perform services within their scope of practice, in the area of Speech Therapy.
Approved Therapy Provider Type and Provider Specialty:
- Provider Type 17 – Therapist
- Provider Specialty 173 – Speech Therapist/Speech and Language Pathologist
Therapy Related Services (Therapists may only provide services within their scope of practice).
Code | Description |
|---|---|
92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder, individual. |
92508 | Treatment of speech, language, voice, communication, and/or auditory processing disorder; group of two or more individuals |
92521 | Evaluation of speech fluency (e.g., stuttering, cluttering) |
92522 | Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria) |
92523 | With evaluation of language comprehension and expression (e.g., articulation, phonological process, apraxia, dysarthria) |
92524 | Behavioral and qualitative analysis of voice resonance |
92526 | Treatment of swallowing dysfunction and/or oral function for feeding |
92610 | Evaluation of oral and pharyngeal swallowing function |
92611 | Motion fluoroscopic evaluation of swallowing function by cine or video recording |
92612 | Flexible fiberoptic endoscopic evaluation of swallowing by cine or video recording |
92614 | Flexible fiberoptic endoscopic evaluation, laryngeal sensory testing by cine or video recording |
92616 | Flexible fiberoptic endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording |
Affected claims for dates of service on or after January 1, 2016 will be reprocessed.
Rationale
- Medicare and Medicaid programs in other states allow speech-language pathologists to enroll as independent providers, and Kansas Medicaid has mirrored Medicare.
- Services of a speech therapist or a speech-language pathologist require a physician prescription, which stands as an indication of the medical necessity for therapy.
- Allowing SP/SLPs to bill for services will promote accuracy in billing when the speech and language pathologist is the performing provider of therapy services.
If you have questions about this bulletin or other provider resources, please contact Customer Service at 1-877-644-4623.