The Virginia Medicaid program has announced it will reimburse school-based speech-language pathology services delivered by telepractice. This announcement follows several years of work that began when members of the Speech-Language-Hearing Association of Virginia and ASHA contacted the Virginia Department of Education (VDOE) and the Department of Medical Assistance Services (DMAS).
With assistance from ASHA staff, the Virginia members began working with DMAS—Virginia's Medicaid agency—to raise awareness of the need for telepractice in the schools and other settings.
DMAS already covered telepractice services delivered by physicians, nurses, nurse midwives, clinical nurse specialists, clinical psychologists, social workers, and licensed counselors, but had not considered including speech-language pathologists in this model.
Medicaid coverage of telepractice services varies widely, as each state administers its own program. States that do provide telepractice coverage all have different regulations on which providers are covered and in what practice settings.
Two simultaneous events in 2009 triggered the collaboration. At a meeting of the American Telemedicine Association, ASHA staff approached the DMAS director, who agreed to look into the issue. At the same time, James Madison University was conducting a pilot project, funded by a VDOE grant, to explore speech-language services delivered by telepractice to students in public schools. Brunswick and Wise County schools participated in the pilot program.
"Collaboration between VDOE and DMAS was critical," said Marie Ireland, an SLP in the special education office of the state department of education. "That initial contact—and the fact that we could point to this state-funded telepractice project—opened the door to everything that followed."
Two years later—and after a series of conference calls, a presentation to Medicaid staff in Richmond, information exchanges, and follow-up with contacts—reimbursed telepractice for school-based SLPs was a reality.
"Follow-up was key to this success," Ireland said. She, ASHA staff members, and a VDOE Medicaid specialist spearheaded the continued advocacy, emphasizing a major benefit of telepractice: improved access to qualified providers.
In March, at the first summit meeting of the Mid-Atlantic Telehealth Resource Center, DMAS announced that speech-language telepractice is now considered a reimbursed Medicaid telemedicine services.
Quoting ASHA's statement that "telepractice is an appropriate model of service delivery for the profession of speech-language pathology and [audiology]," DMAS added that research supports telepractice as a means for delivering speech-language pathology services and that telepractice is simply another option for the delivery of services.
Coverage now includes "speech therapy" services listed in a student's Individualized Education Program provided to the child at school by an SLP at a remote location using videoconferencing.
Providers must continue to meet DMAS school provider qualifications and services must be to a DMAS-enrolled school division. Reimbursement will cover the SLP at the remote location and a qualified school aide with the child during the telepractice session. The aide is billed as a personal care assistant under Virginia Medicaid procedures.
The equipment necessary for telepractice session has been specified by DMAS but is not reimbursable.
Applicable billing codes, all of which must include the "GT" modifier, include assessment (92506), individual visit (92507), group session (92508), and assistant at the student's site (Q3014).
Contact Marie Ireland, MEd, CCC-SLP, specialist in the Virginia Department of Education, at email@example.com.