Billing and Coding: Speech-Language Pathology

Medicare covers speech-language pathology services when they are skilled, medically necessary, and documented with objective evidence of functional progress and measurable treatment goals. Claims must include valid ICD-10-CM diagnosis codes, appropriate referring/ordering physician identifiers when required, and comply with ABN modifier rules (-GA, -GX, -GZ, -GY) and NCCI/OPPS coding edits; improper documentation or use of modifiers may result in automatic denial or returned claims.

"Speech-language pathology services are covered when they are skilled, medically necessary interventions documented in the medical record and intended to produce measurable functional improvement in..."

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