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Speech Therapy - Cigna

Page 1 of 31 Medical Coverage Policy: 0177 Medical Coverage Policy Effective Date .. 3/15/2022 Next Review Date .. 2/15/2023 Coverage Policy Number .. 0177 Speech Therapy Table of Contents Overview .. 1 Coverage Policy .. 1 General Background .. 4 Medicare Coverage Determinations .. 22 Coding/Billing Information .. 22 References .. 23 Related Coverage Resources Attention-Deficit/Hyperactivity Disorder (ADHD): Assessment and Treatment Autism Spectrum Disorders/Pervasive Developmental Disorders: Assessment and Treatment Cochlear and Auditory Brainstem Implants Cognitive Rehabilitation Electric Stimulation for Pain, Swelling and Function in a Clinic Setting Electrical Stimulation Therapy and Home Devices Nutritional Support Occupational Therapy Pediatric Intensive Feeding Programs Sensory and Auditory Integration Therapy - Facilitated Communication Speech Generating Devices INSTRUCTIONS FOR USE The following Coverage Policy applies to health benefit plans administered by Cigna Compa

• The therapy plan includes quantifiable, attainable short- and long-term treatment goals against which progress will be documented. • The treatment includes a transition from one-to-one supervision to an individual or caregiver provided maintenance level on discharge.

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