10.2 Benefits, Limitations, and Authorization RequirementsAn ACD system is also known as an augmentative and alternative communication (AAC) device system. Benefits are limited to the purchase, rental, replacement, modification, and repair of ACDs that function independently of any other technology (i.e., may not rely on a computer in any way) for program-eligible clients when a documented need exists. The following procedure codes must be used to request prior authorization or file claims for the purchase or rental of ACDs:
Items that are included in the reimbursement for an ACD system and are not reimbursed separately include, but are not limited to, the following:
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• It is recommended that the preliminary evaluation for an ACD include the involvement of an occupational or physical therapist to assess the client's seating and postural needs and the motor skills required to use the ACD. Prior authorization is mandatory for:
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• ACDs may be prior-authorized if the following criteria are met:
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• Refer to: Section 4.3, "Prior Authorizations" for detailed information about prior authorization requirements. The "CSHCN Services Program Prior Authorization Request for Augmentative Communication Devices (ACDs)" . |
Applicable software (except for software purchased specifically to enable a client owned computer or a personal digital assistant [PDA] to function as an ACD system)
