Background. As of January 1, 2001, Medicare will cover
and provide reimbursement for some AAC devices (referred to by
Medicare as "speech generating devices" or "SGD").
Medicare AAC device coverage follows the withdrawal of the
long-standing guidance that referred to AAC devices as
"convenience items."
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Who Qualifies? Medicare now classifies AAC devices (SGDs)
as "durable medical equipment," and they are available
to Medicare beneficiaries when the following four criteria are
met:
1) the beneficiary is enrolled in Medicare Part B;
2) the beneficiary lives in his/her family home, or an
assisted living facility (but not in a hospital, skilled nursing
facility, or hospice);
3) the beneficiary is determined, following an assessment by
a speech-language pathologist, to require an AAC device (SGD) to
meet daily functional communication needs; and
4) the beneficiary's physician prescribes the AAC device (SGD).
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What is the RMRP Policy? Medicare has issued a
Regional Medical Review Policy (RMRP) on Speech Generating
Devices (SGDs) that identifies the required components of the
SLP evaluation and report.
Click here for a
complete copy of the RMRP.
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What is the AAC Assessment
/Application Protocol? This AAC Assessment Protocol is
intended as a guide so that speech-language pathologists will
conduct complete assessments and prepare written reports that
address all of the points identified in the RMRP.
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Who Can Conduct the Assessment? The RMRP requires the
assessment to be conducted by a speech-language pathologist
holding a Certificate of Clinical Competence issued by the
American Speech-Language-Hearing Association.
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Can the Assessment be Reimbursed? Yes. Medicare has
established procedure codes and reimbursement rates for SGD
assessments and devices. However, in order to be reimbursed, the
SLP must meet the requirements to be a provider of Medicare
speech-language pathology services.
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Must a Written Report be Prepared? Yes. The SLP
report, consistent with the RMRP, must be completed, and then
sent to the beneficiary's doctor for review. A doctor's
prescription is needed to obtain reimbursement for the
recommended AAC device (SGD) and any software and accessories.
This Assessment /Application Protocol identifies the specific
topics to be addressed in the report.
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Is Additional Help Available? Yes. SLPs with questions
about the AAC Assessment Protocol may contact members of the
Medicare Implementation Team. Contact information is listed at
the end of the Protocol. To obtain more information about
Medicare coverage of AAC devices (SGDs), go to "Frequently
Asked Questions."
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Please note that this site is dynamic and is
changing constantly as new information becomes available. If you
have a question or concern that was previously unaddressed,
please recheck the site, as new information addressing your
concern may have been recently added .
If you have a question or comment regarding the Medicare
Assessment or Application Process for AAC (SGD) devices that is
not addressed within this site, please go to our Medicare
Assessment / Application Process Feedback Page.
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