Speech Generating Devices (SGD) - Policy Article

Speech generating devices (SGDs) are covered under the DME benefit only when they meet DME criteria (durable, expected life ≥3 years, primarily medical use, not useful absent illness, appropriate for home use, limited to patients with severe speech impairment, and primarily used to generate speech/text/phone messages). Non-covered items include general computing devices with non-medical features (must be coded A9270), video conferencing, ISP/phone service, carrying cases (E2599), accessories for non-covered devices, and upgrades within 5 years; specific documentation (SLP evaluation, product/manufacturer details, WOPD/face-to-face for certain codes, and PDAC verification for E2510) and correct modifiers (KX/GA/GZ) are required for payment.

"Device must withstand repeated use to be eligible as durable medical equipment (DME)."

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