1. Medicaid Billing Module Speech Therapy Billing Form

2. 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.

3. 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. 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

4. 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

5. 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

6. ICD 10 Diagnosis Codes for Speech Services Continued R47.01 Aphasia R47.02 Dysphasia R47.1 Dysarthria and anarthria R47.8 Slurred Speech R47.82 Fluency Disorder in conditions classified elsewhere

7. ICD 10 Diagnosis Codes for Speech Services Continued 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

8. 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.

9. 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.

10. Student Demographics Sample Medicaid NumberLast NameFirst Name 00000000000DoeJane WVEIS NumberDiagnosis CodeDate of Birth 999999999F80201-01-1900 CountySchoolProvider Name 059203

11. 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.

12. Procedures # 92507 Dates of Service/units # 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 #92524 Date of Service #92561 Date of Service #92567 Date of Service 8-17-15 /2 8-19-15 / 2 8-24-15 /2 #92570 Date of Service #92583 Date of Service #92592 Date of Service #92593 Date of Service 8-31-15 /2

13. Explanation of Procedures and Caps Code Procedure Service Unit 92507Treatment of speech language, voice, communication, and/or auditory processing disorder (includes aural rehabilitation); Individual therapy session 16 units per month at 15 minutes per unit 92508Treatment of speech language, voice, communication, and/or auditory processing disorder (includes aural rehabilitation); Group, two or more individuals 16 units per month at 15 minutes per unit 92521Evaluation of speech fluency (e.g., stuttering, cluttering)1 per calendar year 92522*Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria) 1 per calendar year 92523*Evaluation of speech production (e.g., articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language) 1 per calendar year 92524Behavioral and qualitative analysis of voice and resonance1 per calendar year 92561Beskey Diagnostic1 per calendar year 92567Tympanometry (impedance testing) Can also be performed by RN1 per calendar year 92570Acoustic Immitance Testing Can also be performed by RN4 per calendar year 92583Select Picture Audiometry1 per calendar year 92592Hearing Aid Check - Monaural4 per calendar year 92593Hearing Aid Check-Binaural4 per calendar year

14. 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.

15. Start and Stop Times Date123456789101112131415 Start Time End Time Date16171819202122232425262728293031 Start Time End Time

16. 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.

17. 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)

18. 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.

19. 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 tjriley@k12.wv.us http://wvde.state.wv.us/osp/medicaid.html