woodbury

 

Speech Therapy

Provider Requirements and Service Limitations

From The July 2007 Florida Medicaid Provider Handbook

Speech Therapy - Requirements To Receive

Description

Speech therapy is a service prescribed by a physician and is necessary to
produce specific functional outcomes in the communication skills of a recipient
with a speech, hearing or language disability. The service may also include a
speech therapy assessment, which does not require a physician’s prescription.
In addition, this service may include training and monitoring of direct care staff
and caregivers, to ensure they are carrying out therapy goals correctly.

Limitations

Speech therapy and assessment services are available through the Medicaid
Therapy Services Program state plan services for recipients under the age of 21.
Services for these recipients may not be purchased under the waiver. Children
receiving this service through a school health program are still eligible for
medically necessary services funded by Medicaid state plan coverage. When
additional therapy is necessary, families must seek Medicaid state plan services
coverage.
Assessments for augmentative communication devices and assessments for
training are covered by the Medicaid Therapy Services Program state plan
services for all Medicaid recipients.
A recipient shall receive no more than eight units of this service per day. A unit is
defined as a 15-minute time period or portion thereof. The speech therapy
assessment is limited to one per year.

Documentation Requirements
Reimbursement* and monitoring documentation to be maintained by the provider:
1. *Copy of claim(s) submitted for payment;
2. *Copy of service log;
3. *Monthly summary note;
4. *Assessment report, if requesting reimbursement for assessment;
5. Original prescription for the service; and
6. Annual report.
Documentation to be submitted to the waiver support coordinator by the provider:
1. Copy of service log, monthly;
2. Copy of assessment report prior to or at time of initial claim submission;
3. Copy of annual report prior to the annual support plan update; and
4. Copy of original prescription for the service.
*Indicates reimbursement documentation.
Note: The Florida Medicaid Therapy Services Coverage and Limitations
Handbook is available on the Medicaid fiscal agent’s Web Portal at
http://mymedicaid-florida.com. Click on Public Information for Providers, then on
Provider Support, and then on Provider Handbooks. The therapy handbook is
incorporated by reference in rule 59G-4.320, F.A.C.

Place of Service
This service may be provided in the therapist’s office, in the recipient’s place of
residence, or anywhere in the community

Speech Therapy Provider Requirements

Speech Therapy Provider Requirements

Provider Qualifications
Providers of speech therapy and assessment services shall be speechlanguage
pathologists and speech-language pathology assistants licensed by
the Department of Health, in accordance with Chapter 468, Part I, F.S., and
may perform services within the scope of their licenses.
Speech-language pathologists and assistants may provide this service as an
independent vendor or as an employee of an agency. Speech therapists may
also provide and bill for the services of a licensed or certified speech therapy
assistant. Only licensed speech therapists can perform assessments.
Speech-language pathologists with a master’s degree in speech language
pathology who are in their final clinical year of training may also provide this
service. Speech-language assistants must be supervised by a speechlanguage
pathologist in accordance with the requirements of their
professional licenses, per Chapter 468, Part I, F.S.

Training Requirements
The provider is responsible for all training requirements outlined in the Core
Assurances.
Note: Refer to the Core Assurances in Appendix A for the provider training
requirements.