Reimbursement Tips Reimbursement for dysphagia services is an ever-evolving system. The easiest system to monitor is Medicare. Medicare specifically covers speech-language pathology services for the treatment of dysphagia. Section 170.3 of the Medicare National Coverage Determinations Manual (CMS-A, 2003) states that speech-language pathology services for dysphagia “are covered under Medicare for ... Article
Article  |   March 01, 2004
Reimbursement Tips
Author Affiliations & Notes
  • Nancy B. Swigert
    Swigert & Associates, Inc, Lexington, KY
  • Steven C. White
    Health Care Economics and Advocacy, ASHA
  • Mark L. Kander
    Health Care Economics and Advocacy, ASHA
Article Information
Swallowing, Dysphagia & Feeding Disorders / Practice Management / Professional Issues & Training / Regulatory, Legislative & Advocacy / Articles
Article   |   March 01, 2004
Reimbursement Tips
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), March 2004, Vol. 13, 16-20. doi:10.1044/sasd13.1.16
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), March 2004, Vol. 13, 16-20. doi:10.1044/sasd13.1.16
Reimbursement for dysphagia services is an ever-evolving system. The easiest system to monitor is Medicare. Medicare specifically covers speech-language pathology services for the treatment of dysphagia. Section 170.3 of the Medicare National Coverage Determinations Manual (CMS-A, 2003) states that speech-language pathology services for dysphagia “are covered under Medicare for the treatment of dysphagia, regardless of the presence of a communication disability” (p. 49). The section also gives fundamental guidance regarding documentation of services to patients with dysphagia. Your records need to indicate that the patient is, at a minimum, “motivated, moderately alert, and (has) some degree of deglutition and swallowing functions” (p. 49) that make the patient an appropriate candidate for dysphagia therapy. The coverage manual also states that the therapy program can include thermal stimulation, exercises to improve oral-motor control, training in laryngeal adduction and compensatory swallowing techniques, and positioning and dietary modifications. Last, the coverage manual states, “design all programs to ensure swallowing safety of the patient during oral feedings and maintain adequate nutrition” (p. 50). Documentation consistent with the coverage criteria should be the first step in both the plan of treatment and progress notes.
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