speech language pathology (slp) therapy

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MEDICAID BILLING REQUIREMENTS

CLARIFICATIONS: SPEECH LANGUAGE PATHOLOGY (SLP) THERAPY

The following chart includes the three types of staff who can provide speech therapy in the school settings. This chart illustrates the services each employee category can perform.

Provide Therapy

Speech Language

Pathologist (SLP) Board of Examiner & WVDE

Certified

YES

Speech Language

Pathologist (SLP)

WVDE Certified

YES

*Speech Language

Pathology Assistant

(SLPA) WVDE Authorized

YES

Conduct Evaluations

SLPA Plan Required

YES

NO

YES

NO

NO

YES

Can Supervise an SLPA YES YES

*See the SLPA Guidance Document for further details in the scope of an SLPA.

The following chart addresses Medicaid billing requirements as of August 1, 2015:

SLP Board of

Examiner & WVDE

Certified

MEDICAID Credential required on billing forms

Speech Language

Pathologist (SLP)

SLP WVDE Certified

School Speech

Language Pathology

Assistant (SSLPA)

NO

SLPA WVDE Authorized

School Speech

Language Pathology

Assistant (SSLPA)

Bill for therapy

Bill for evaluation

Bill for Targeted Case

Management (TCM)

YES

YES

YES

YES**

NO

YES

YES**

NO

YES

Enrolled as provider YES NO NO

Fingerprint required YES YES YES

Place on Random

Moment Time Study

(RMTS) roster YES YES YES

**SSLPAs can only bill for speech therapy if the county/LEA has an enrolled Board of Examiner licensed SLP, with a

National Provider Number that allows billing through their credentials.

Note: There is not a limit to the number of SSLPAs or students who can be billed through one Board of

Examiner SLP. The Board licensed SLP WILL NOT CO-SIGN or directly supervise SSLPAs for Medicaid

purposes. The Board licensed SLP is NOT required to be on-site during SSLPA therapy. The SSLPA will be indirectly supervised by an SLP associated with the county/LEA that they are employed. The SLP must be available in case of any emergent issues. If there is an audit or concern involving an SSLPA’s documentation, the individual SSLPA will be responsible to justify their Medicaid documentation.

SSLPAs can bill for TCM.

Kathy Hudnall

WVDE Coordinator, Speech-Language Pathology

Terry Riley

WVDE Coordinator, Medicaid

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