Speech Language Pathology (SLP) Services

Covered: skilled SLP habilitation, rehabilitation, and limited maintenance for cognitive-communication, hearing/auditory processing, language, speech production, and swallowing/feeding disorders when they address documented functional limitations in ADLs/IADLs; excluded: non‑skilled/routine/preventive/elective services, experimental/investigational interventions (including NMES/electrical stimulation alone), services for reading/writing/spelling absent a significant language deficit, and care justified solely by caregiver unavailability or noncompliance. Key requirements: services must meet the policy’s “medically necessary” definition and require qualified-provider skill, be supported by standardized (and culturally/linguistically appropriate) baseline and follow‑up assessments (audiology eval for APD, VFSS/nutrition data for dysphagia, etc.), show reasonable expectation of response and patient/caregiver adherence, and include documentation for initiation/continuation with individualized medical necessity (subject to plan visit limits).