Typically, procedure code 97535 is used for speech therapy training for augmentative communication devices (ACD). Prior authorization requests and claims with procedure code 97535 and modifier GN must be submitted for speech therapy services.

Effective January 1, 2010, providers must request procedure code 97535 separately from other therapy services with the appropriate modifier and specify the amount of this procedure code requested. Procedure code 97535 will not be routinely included in the physical and occupation therapy authorizations and in the procedure codes listed in the PT and OT authorization letters.

When requesting prior authorization for physical, occupational, or speech therapy, service providers must include the frequency and amount of time they are requesting.

For more information, call the TMHP Contact Center at 1-800-925-9126.