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The Centers for Medicare and Medicaid Services (CMS) has recommended that speech-language pathologists use ASHA's National Outcomes Measurement System (NOMS) to document a patient's functional improvement and justify services eligible for the Medicare therapy cap exceptions process. Of four CMS-approved assessment tools, NOMS is the only one that accounts for communication and swallowing. The other instruments address physical and occupational therapy. CMS also indicates that SLPs who don't use one of the four assessment tools must provide documentation to indicate objective, measurable beneficiary function.
NOMS is a data collection system developed to illustrate the value of speech-language pathology services provided to adults and children with communication and swallowing disorders. The key to NOMS is the use of ASHA's Functional Communication Measures (FCMs), a series of disorder-specific, seven-point rating scales designed to describe the change in an individual's functional communication ability over time. The FCMs are not dependent upon administration of any particular formal or informal assessment measures, but are SLP-provided clinical observations of the patient's communication and/or swallowing abilities to be addressed in an individualized treatment plan. SLPs must be NOMS-certified to use the tool, which is free to ASHA members.
For further information on NOMS, visit National Center for Treatment Effectiveness in Communication Disorders or contact Tobi Frymark, associate director of ASHA's National Center for Evidence-Based Practice, at tfrymark@asha.org or 800-498-2071, ext. 4330.
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