Speech Language Pathology (SLP) Services

Skilled SLP services (rehabilitative, habilitative, and health-plan‑covered maintenance) are covered for documented speech, language, cognitive-communication, auditory, or swallowing impairments that limit ADLs/IADLs, while routine/preventive, recreational, reading/writing‑only without spoken‑language deficit, duplicative, non‑skilled services (including NMES alone) are excluded. Coverage requires a qualified provider’s documented need, standardized/formal baseline and reassessment data, a reasonable plan of care expected to produce measurable improvement with patient/caregiver compliance, and condition‑specific testing (e.g., audiology, standardized speech/language/swallow assessments) with demonstrated progress or significant change for continuation/maintenance.

"Documentation of caregiver training provided and the individual's/caregiver's ability to carry out established maintenance/home programs when applicable."