Speech Therapy

Covered: physician‑ordered evaluation and skilled SLP services for speech, language, voice, swallowing/dysphagia, cognitive‑communication, habilitation/maintenance (including early intervention/ASD and aural rehab); excluded: non‑skilled/repetitive procedures, services by unlicensed aides/SLP‑assistants, preventive/palliative‑only care, accent‑modification/enhancement‑only therapies, duplicate or self‑resolving conditions and other listed exclusions. Key requirements: services require a physician order and a documented plan of care with baseline measures and measurable goals, skilled SLP judgment, periodic reassessments (adults ~30–60 days; children birth–21 ~6–9 months), specified prior‑authorization/documentation timelines (initial auth typically within 7 days of evaluation), and adherence to group‑therapy (≤4) and instrumental swallowing assessment criteria.

"The goals are duplicative in nature to another therapist's current treatment plan (typically Occupational therapist)."