Transcription of Speech Language Pathology Services - UHCprovider.com
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Speech Language Pathology Services - UHCprovider.com
Speech Language Pathology Services Page 1 of 13 UnitedHealthcare Community Plan Coverage Determination Guideline Effective 04/01/2022 Proprietary Information of UnitedHealthcare. Copyright 2022 United HealthCare Services , Inc. UnitedHealthcare Community Plan Covera ge Deter mina tion Guideline Speech Language Pathology Services Guideline Number: Effective Date: April 1, 2022 Instructions for Use Table of Contents Page Application .. 1 Coverage Rationale .. 1 Definitions .. 8 Applicable Codes .. 11 References .. 12 Guideline History/Revision Information .. 12 Instructions for 12 Application This Coverage Determination Guideline only applies to the states of Arizona, California, Hawaii, Kansas, Maryland, Michigan, New York, Ohio, Rhode Island, Virginia, Washington, and Wisconsin.
o Post cochlear implant o Quadriplegia o Traumatic brain injury Medical complications related to the following: o Immediately following amputation o Major multiple trauma o Post-acute stroke ... A comparison prior level of function to current level of function, as applicable; and
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