Augmentative and Alternative Communication (AAC) Devices for Speech Impairment

CMS NCA document | source_status=Closed | review_type=New | public_comment_open=False | document_id=CAG-00055N

We believe that most of the disease entities for which coverage of AAC devices might be appropriate will require an neurologist's assessment of the etiology of the speech loss, the type of speech loss, the severity of loss and the presence or absence of excluding conditions before a specific recommendation for the equipment could be made. Comments on specific tests, if any, which should be included in that assessment to ensure that the patient has sufficient cognitive and physical capacity to be able to effectively use AAC equipment, are requested. We would like recommendations as to the number of visits with a speech language pathologist which are necessary for training of the patient in the use of a particular AAC device and in customizing its features to meet the patient's medical needs. Can the speech language community develop valid and reliable objective measures for assessing the benefits realized from an AAC device in each patient at specified periods after the device has been provided? We are interested in comments from speech language pathologists, treating physicians and ancillary personnel on this issue. This may be an ongoing process. We do not address duration of use as a coverage criterion here, but this may be dealt with by other components within HCFA as a condition of payment. Implementation instructions to contractors will follow and the effective date for this decision will be no later than January 1, 2001.