Medicaid Billing Module
Speech Therapy Billing Form
Changes
• Services must be documented on the current IEP for
meetings held prior to August 1, 2015.
• Services must be documented on Service Care Plan
for IEP meetings held after August 1, 2015.
• As of August 1, 2015 Speech specific ICD diagnosis
codes are required. ICD-9 codes are in effect through
September 30, 2015. ICD codes must relate to the
specific type of therapy being provided. A global code
such as Autism would not be sufficient.
• As of October 1, 2015 Speech specific ICD-10
diagnosis codes are required.
ICD 10 Diagnosis Codes
Typically Used for Speech Services
This is not a complete list of ICD 10 codes. These are
the most frequently codes used by speech therapists. If
there are additional codes you need to use, send this
information to Terry Riley at the e-mail on the last page.
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F80.0 Phonological disorder (Articulation)
F80.1 Expressive language disorder
F80.2 Mixed receptive-expressive language disorder
F80.4 Speech and language development delay due
to hearing loss
ICD 10 Diagnosis Codes for
Speech Services Continued
• F80.81 Childhood onset fluency disorder
• F80.89 Other developmental disorders of
speech and language
• F80.9 Developmental disorder of speech
and language, unspecified
ICD 10 Diagnosis Codes for
Speech Services Continued
• Q38.3 Other congenital malformations of
tongue (tongue thrust)
• R13.0 Aphagia
• R13.10 Dysphagia, unspecified
• R13.11 Dysphagia, oral phase
• R13.19 Other dysphagia
ICD 10 Diagnosis Codes for
Speech Services Continued
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R47.01 Aphasia
R47.02 Dysphasia
R47.1 Dysarthria and anarthria
R47.8 Slurred Speech
R47.82 Fluency Disorder in conditions
classified elsewhere
ICD 10 Diagnosis Codes for
Speech Services Continued
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•
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R49.0 Dysphonia (Hoarseness)
R49.1 Aphonia (Loss of Voice)
R49.21 Hypernasality
R49.22 Hyponasality
R49.8 Other voice and resonance
disorders
• R62.0 Delayed milestone in childhood
Physician Authorization
• Physician Authorization is still required annually to
bill for speech services.
• Authorization can now be from a Physician's
Assistant or an Advanced Practice Registered
Nurse (APRN).
• Authorization is good for one calendar year from
the date signed.
• ICD10 codes assigned by therapist are placed on
authorization form. Physician is confirming those
diagnosis codes when signing.
Student Demographics
• Complete this section taking note of the
following issues
• The diagnosis code is to be an ICD 10
code that matches the need for speech
therapy and service(s) being provided.
• For provider name print the name of the
person providing the service.
Student Demographics Sample
Medicaid Number
Last Name
First Name
00000000000
Doe
Jane
WVEIS Number
Diagnosis Code
Date of Birth
999999999
F802
01-01-1900
County
School
Provider Name
059
203
Procedure Codes
• Complete date of service and number of
units under the appropriate heading for
each day of therapy/evaluation.
• There are two columns for individual
therapy and group therapy.
• If the Service was provided through
Telehealth add GT to the date’s service.
Procedures
# 92507
Dates of
Service/units
8-17-15 /2
8-24-15 /2
8-31-15 /2
# 92507
Dates of
Service/units
# 92508
Date of
Service/Units
# 92508
Date of
Service/units
#92521
Date of
Service
#92522
Date of
Service
#92523
Date of
Service
#92570
Date of
Service
#92583
Date of
Service
#92592
Date of
Service
#92524
Date of
Service
8-19-15 / 2
#92593
Date of
Service
#92561
Date of
Service
#92567
Date of
Service
Explanation of Procedures
and Caps
Code
92507
92508
92521
92522*
92523*
92524
92561
92567
92570
92583
92592
92593
Procedure
Treatment of speech language, voice, communication, and/or auditory processing
disorder (includes aural rehabilitation); Individual therapy session
Treatment of speech language, voice, communication, and/or auditory processing
disorder (includes aural rehabilitation); Group, two or more individuals
Evaluation of speech fluency (e.g., stuttering, cluttering)
Evaluation of speech sound production (e.g., articulation, phonological process,
apraxia, dysarthria)
Evaluation of speech production (e.g., articulation, phonological process, apraxia,
dysarthria); with evaluation of language comprehension and expression (e.g.,
receptive and expressive language)
Behavioral and qualitative analysis of voice and resonance
Beskey Diagnostic
Tympanometry (impedance testing) Can also be performed by RN
Acoustic Immitance Testing Can also be performed by RN
Select Picture Audiometry
Hearing Aid Check - Monaural
Hearing Aid Check-Binaural
Service Unit
16 units per month at 15
minutes per unit
16 units per month at 15
minutes per unit
1 per calendar year
1 per calendar year
1 per calendar year
1 per calendar year
1 per calendar year
1 per calendar year
4 per calendar year
1 per calendar year
4 per calendar year
4 per calendar year
Start and Stop Times
• Enter the start and stop times for each
service on the corresponding date at the
bottom of the form.
• These will be used to easily identify dates
billable services were conducted for
students with transportation services.
Start and Stop Times
Date
Start
Time
End
Time
1
Date
Start
Time
End
Time
16
2
17
3
4
5
6
18
19
20
21
7
22
8
23
9
24
10
25
11
26
27
12
28
13
29
14
30
15
31
Additional Documentation
• Progress/therapy logs will also be
required.
• Original copies of progress/therapy logs
must be on file in the special education
central office.
• There is not a required form for
documentation of progress/therapy logs.
Signature and Credentials
• Staff who provided the service will sign the
form and list credentials.
• For Therapists licensed by the WV Board
of Examiners list credential as SLP.
• Therapists licensed by WVDE and SLPAs
authorized by WVDE must list their
credential as SSLPA (School Speech
Language Pathologist Assist)
SSLPA
• An SSLPA can provide therapy but not
evaluations for Medicaid billing purposes.
• For an SSLPA to bill they must be
indirectly supervised by an SLP.
Terry Riley – Coordinator
Office of Special Education
tjriley@k12.wv.us
304-957-9833 ext 53223
WVDE Medicaid Website:
http://wvde.state.wv.us/osp/medicaid.html