Speech and Language Pathology and Audiology Services

Revised: January 16, 2025

Return to IEP Home

· Overview

· Authorization Requirements

· Eligible Providers

· Covered Services

· Noncovered Services

· Health Records and Documentation

· Billing

· Legal References

Overview

The practice of speech-language pathology means identification, assessment, interpretation, diagnosis, habilitation, rehabilitation, treatment and prevention of disorders of speech articulation, fluency, voice and language.

The practice of audiology means identification, assessment, interpretation, diagnosis, rehabilitation and prevention of hearing disorders.

Authorization Requirements

The Individualized Education Program (IEP) team authorizes services included in an IEP or Individualized Family Service Plan (IFSP). Physicians (primary care providers) orders or referrals are not required. The licensed speech and language pathologist or audiologist working within his or her scope of practice will evaluate services needed, develop the treatment plan and goals or the care plan, treat the patient, or supervise and give direction to a clinical fellowship licensee.

Eligible Providers

The following providers can perform speech or audiology services:

· Audiologist: A person who has a master’s degree or doctoral degree, meets the requirements under Minnesota Statutes, 148.511-148.5198 and is licensed by the Minnesota Department of Health (MDH)

· (Educational) speech and language pathologist: A person who meets the requirements in Minnesota Statutes, 256B.0625, subdivision 26, holds a master’s degree in speech-language pathology, is licensed by the Minnesota Professional Educator Licensing and Standards Board as an educational speech-language pathologist and either has a Certificate of Clinical Competence (CCC) from the American Speech and Hearing Association or has completed the equivalent educational requirements and work experience necessary for the certificate, or is completing a supervised clinical fellowship

· Speech and language pathologist (SLP): A person who has a master’s degree or doctoral degree in speech-language pathology, meets the requirements in Minnesota Statutes, 148.511-148.5198 and is licensed by MDH

· Clinical fellowship licensee: A person who has a master’s degree and is completing a supervised clinical fellowship in speech-language pathology or audiology according to the requirement in Minnesota Statutes, 148.511-148.5196 (This program is available for a limited time.)

Covered Services

Minnesota Health Care Programs (MHCP) covers the following services:

· Individual and group speech and language pathology services provided by a speech and language pathologist, an educational speech or language pathologist who meets the requirements, or a clinical fellowship licensee

· Audiology services provided by an audiologist

· Specialized maintenance therapy provided by a speech-language pathologist and that is specified in the child’s IEP or IFSP and is necessary for maintaining a child’s functional status at a level consistent with the child’s physical or mental limitations. Specialized maintenance therapy must meet one of the following: prevent deterioration and sustain function; provide interventions that enable the child to live at his or her highest level of independence (in the case of chronic or progressive disability); or, provide treatment interventions for children who are progressing, but not at a rate comparable to expectations of restorative care

· Some telemedicine services provided by a speech-language pathologist

· Face-to-face assessments, interpreting test results and writing reports (meetings to discuss evaluation results or make recommendations are not covered).

Refer to coverage criteria Covered and Noncovered IEP Health-Related Services section.

Noncovered Services

Refer to the Covered and Noncovered Services sections for an overview of noncovered services that would apply to all IEP services.

Health Records and Documentation

Review the Record Keeping and Documentation section for an overview of the basic IEP record keeping, documentation service time and encounter reporting requirements.

Billing

Submit claims using the 837P Professional claim type. Refer to the MN–ITS IEP User Guide for step-by-step instructions for direct data entry claims. Batch billers submitting X12 837P claims may review the MHCP 5010/D.0 Compliance webpage and the AUC Minnesota Uniform Companion Guide for transaction guideline.

Review the Billing and Authorization section for general billing requirements.

Legal References

Minnesota Statutes, 148.515 (Qualifications for Licensure)
Minnesota Statutes, 256B.0625, subdivision 26(c) (Covered Services) (Special education services)
Minnesota Rules 9505.0390, subpart 1 (L) (Rehabilitation and Therapeutic Services) (Definitions)