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42.6.7.2 Description of Services
Speech evaluation services include the identification of children with speech and/or language disorders and the diagnosis and appraisal of specific speech and language disorders. Speech therapy services include the provision of speech and language services for the habilitation or prevention of communicative disorders.
Speech evaluation is billable on an individual (1-92506 with modifier GN) basis only. Speech therapy is billable on an individual (1-92507) or group (1-92508) basis. Providers can only bill time spent with the student present, including assisting the student with learning to use adaptive equipment and assistive technology. Time spent without the student present, such as report writing and training teachers or aides to work with the student (unless the student is present during training), is not billable. Session notes are not required for procedure code 1-92506; however, documentation must include the billable start time, billable stop time, total billable minutes, and must note the activity that was performed (e.g., speech evaluation). Session notes are required for procedure codes 1-92507 and 1-92508. Session notes must include the billable start time, billable stop time, total billable minutes, activity performed during the session, student observation, and the related IEP objective.
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