|
29.3 Benefits and Limitations
SLP services for a client must be medically necessary, prescribed by a physician, and provided by a speech-language pathologist (SLP) that is licensed by the state of Texas.
The CSHCN Services Program SLP services benefit may be limited to certain conditions, by type of service, by age, by the client's medical status, and whether the client is eligible for services that a school district is legally responsible to provide. SLP services are benefits when provided to clients experiencing speech-language difficulty because of a disease or trauma, developmental delay, oral motor problem, or congenital anomaly.
Clients can receive SLP services from both the CSHCN Services Program and from other sources, such as from school districts, only when the therapy provided by the CSHCN Services Program addresses different client needs. Therapy provided by the CSHCN Services Program is not intended to duplicate, supplement, or replace services that are the legal responsibility of other entities or institutions. The CSHCN Services Program encourages the private therapist to coordinate with other therapy providers to avoid treatment plans that might compromise the client's progress.
Specific procedure or diagnosis codes related to program benefits are listed in this chapter. These listings are intended to provide helpful information, but should not be considered all-inclusive. From time to time, codes are added, deleted, or revised. Benefit and coding information is updated in the CSHCN Services Program Provider Bulletin.
|
