Speech-Language Pathology Services for the Treatment of Dysphagia

CMS National Coverage Determination | ncd_id=192 | manual_section=170.3 | coverage_level_code=1 | national_coverage_type=True | under_review=False | lab_ncd=False

Speech-language pathology services are covered under Medicare for the treatment of dysphagia, regardless of the presence of a communication disability.

Item/Service Description: Dysphagia is a swallowing disorder that may be due to various neurological, structural, and cognitive deficits. Dysphagia may be the result of head trauma, cerebrovascular accident, neuromuscular degenerative diseases, head and neck cancer, and encephalopathies. While dysphagia can afflict any age group, it most often appears among the elderly. Patients who are motivated, moderately alert, and have some degree of deglutition and swallowing functions are appropriate candidates for dysphagia therapy. Elements of the therapy program can include thermal stimulation to heighten the sensitivity of the swallowing reflex, exercises to improve oral-motor control, training in laryngeal adduction and compensatory swallowing techniques, and positioning and dietary modifications. Design all programs to ensure swallowing safety of the patient during oral feedings and maintain adequate nutrition. Cross Reference: The Medicare Benefit Policy Manual , Chapter 15, "Covered Medical and Other Health Services," §§220 and 230.3. Revision History: 05/2006 - Issued. Effective date: 10/01/2006. ( TN 55 ) CR4014 08/1989 - Covered regardless of presence of a communication disability. Effective date 08/28/1989. (TN 39) Benefit Categories: 49 - Outpatient Speech Language Pathology Services Transmittal: transmittal_number=55 | transmittal_issue_date=2006-05-05 | change_request_number=4014