Common Questions about Speech Language Pathology (SLP) Billing
Many people perceive January 1 as a good time to set goals and broaden their knowledge or skill set. Some may learn a new language, while others may read more novels throughout the year. One New Year's resolution for speech-language pathologists might be to brush up on Speech Language Pathology (SLP) Billing best practices. After all, with Medicare's recent reduction in reimbursement for therapy services, making every claim count in the new year will be more critical than ever.
With that in mind, here are common questions about Insurance billing for outpatient services that every SLP should be aware of:
Do SLPs work with patients or clients?
SLPs work with clients/patients of all ages in their homes or outpatient settings like speech and hearing clinics or doctors' offices. SLPs who provide home care services may work for home health care agencies, early intervention programs, or in private practice.
Can a speech-language pathologist bill Medicare directly?
Speech-language pathologists can enroll as Medicare providers under the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008. Although a physician order or referral is not required (unless required by state law), the physician must validate the plan of care within 30 days and regularly after that.
Why doesn't health insurance cover speech therapy?
Many insurance companies do not cover developmental or chronic conditions. For example, if a child has a speech lisp, delay, or another type of articulation disorder, their therapy may not be covered or may be limited.
What exactly are SLP CPT billing codes?
Speech-language pathologists’ services may be coded as CPT codes 92507, 92508, or 92526. They do not provide CPT codes 97110, 97112, 97150, or 97530 services, which physical or occupational therapists typically provide.
What is the distinction between a speech-generating and a non-speech-generating device?
Speech-generating devices produce digital or synthesized speech. HCPCS for speech-language pathology offers a list of E codes for each type of speech-generating device. On the other hand, non-speech-generating devices are low-tech electronic or mechanical communication aids with a different set of codes. Contact your medical payments if you require additional assistance determining the device type.
What procedure codes do speech-language pathologists use in any setting?
The CPT code for fibreoptic endoscopic evaluation of swallowing (FEES) is 92612, whereas code 92616 is used if sensory testing is included (FEEST). Furthermore, CPT 92597 is the code for voice prosthetics evaluation. The service code 92507 denotes training and modification in the use of a voice prosthetic.
Is it possible for a speech-language pathologist to use 97000 codes (physical medicine)?
Clinicians should utilize the "best" code to describe services, which may be in the 92000 or 97000 series. CPT code 92507 (treatment of speech-language services) is comprehensive and covers almost all aspects of treatment. Using a 92000 code in conjunction with a 97000 code may result in code unbundling, which is not permitted.
Should 97000 (physical medicine) codes be billed instead of or in addition to speech-language treatment codes?
Medicare enables speech-language pathologists to use 97129 (cognitive function intervention, initial 15 minutes) and 97130 (cognitive function intervention, each additional 15 minutes) for the treatment of cognitive disorders. It is important to note that either code 92507 or 91729/97130 may be used, but not both on the same day by the same provider. Nonetheless, many Medicare providers may question a speech-language pathologist's use of other 97000 series Physical Medicine codes.
Can the speech treatment code (92507) and the speech group code (92508) both be billed on the same day?
Yes, if both interventions are delivered. If CCI edits are delivered on the same day as 92507, a 59 modifier must be added to the 92508 codes.
What can be the best solution for Speech-Language Pathology (SLP) Billing?
As a Speech Language Pathologist, time and energy spent on mundane tasks such as medical billing can divert your attention and that of your critical staff away from what you do best! 24/7 Medical Billing Services is your best solution for easing your Speech Language Pathology (SLP) Billing.
We can significantly reduce the medical billing process for your SLP practice. The goal is to assist you in expanding your patient services as your practice grows and scales. To streamline the medical billing process, our SLP medical billing professionals take a hands-on, meticulous approach. This ensures prompt payment while avoiding billing code errors and denying patient insurance claims.
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