S9152 — Speech therapy, re-evaluation
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- The treatment goals and subsequent documentation of treatment results should specifically demonstrate that speech therapy services are contributing to such improvement.
- Speech therapy must be provided in accordance with an ongoing, written plan of care that is reviewed with and approved by the treating physician and maintained in the medical record.
- The plan of care must be signed by the member's attending physician and the speech therapist.
- The plan of care must include the date of onset or exacerbation of the disorder/diagnosis.
Key Coverage Criteria
- Z96.21 Presence of cochlear implant status
- Z96.3 Presence of artificial larynx
- CPT/HCPCS services covered if selection criteria are met (examples listed in the policy):
- Z96.20 Presence of otological and audiological implant, unspecified
- CPT 92630 - Auditory rehabilitation; pre-lingual hearing loss (covered if selection criteria are met).
- CPT 92633 - Auditory rehabilitation; post-lingual hearing loss (covered if selection criteria are met).
3 Active Policies
CIGNA-CPG111 — Patient Assessments: Medical Necessity Decision Assist Guideline for Evaluations and Re-evaluations - (CPG111)
AETNA-CPB-0243 — Speech Therapy
CARELON-physical-therapy-occupational-therapy-and-speech-therapy-2024-04-14 — Physical Therapy Occupational Therapy and Speech Therapy
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.