Medicare Coverage of Cognitive Therapy by Speech-Language Pathologists

Following are Medicare policy statements that support coverage of cognitive therapy by speech-language pathologists:

1. Program Memorandum AB-00-14.60, March 2000 (page 3)

"Coding - Intermediaries and Carriers"

Question 7: Is there a specific HCPCS code or range of HCPCS codes to report for cognitive speech therapy training?

Answer: For cognitive speech therapy, a speech-language pathologist could use either code [CPT] 92507 or 97770 but not both for the same treatment.

ASHA note: Effective January 1, 2001, CPT 97770, Cognitive skills training, was deleted and divided into two new CPT codes: 97532, Development of cognitive skills; and 97533, Sensory integrative techniques.

Retrieve the Program Memo directly from the CMS website [PDF].

2. Federal Register, January 4, 2001 (page 925)

Preamble to final rule: Medicare and Medicaid Programs; Physicians' Referrals to Health Care Entities

As we developed the list of CPT and HCPCS codes relevant to speech-language pathology, we realized that our proposed definition, which cross-refers to the CORF definition in § 410.100(d), did not encompass the full range of services that are commonly considered to be speech-language pathology services. It failed to recognize that speech-language difficulties can be caused by cognitive disorders and failed to recognize that speech-language pathology may be used to treat swallowing and other oral-motor dysfunctions. Therefore, in developing the list of codes for speech pathology in Phase I of this rulemaking, we included the diagnosis and treatment of cognitive disorders including swallowing and other oral-motor dysfunctions. Finally, because of the overlap between physical therapy, occupational therapy, and speech-language pathology services, we are listing the codes for all three services together. We believe that this set of HCPCS codes represents what most clinicians would define as PT/OT/ speech therapy services that are covered by the Medicare program. The list is set out in the attachment to this final rule.

3. Program Memorandum AB-01-135, September 25, 2001

"Medical Review of Services for Patients with Dementia"

The second paragraph of this Program Memo states:

"Dementia is the general loss of cognitive abilities, including an impairment of memory, and may include one or more of the following: aphasia, apraxia, agnosia, or disturbed planning, organizing, and abstract thinking abilities...Throughout the course of their disease, patients with dementia may benefit from pharmacologic, physical, occupational, speech-language, and other therapies."

Retrieve the Program Memo directly from the CMS website [PDF].

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