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Speech-Language Pathology Private Practice Payment Policy—Are You Ready?

The Speech Therapy billing rules go into effect July 1. Medicare recently issued a MLN Matters article...

Are you a private practice who employs a Speech Pathologist? If yes, you begin billing for the services of these providers to Medicare using their own NPI’s effective July 1, 2009.

Previously KarenZupko & Associates, Inc. recommended practices obtain NPIs for these providers in order to be prepared for this policy change. In CR 6381, Medicare announced the effective dates of billing and credentialing.

CMS defines a Speech Language Pathologist (SLP) as being in private practice, "if the therapist maintains office space at his or her own expense and furnishes services only in that space or in the patient’s home; or is employed by another supplier of services such as a physician or another therapist and furnishes services in settings where therapy is provided at the expense of that supplier."

Effective July 2, 2009 SLPs in private practice will be allowed to bill Medicare and receive direct payment for their services. CMS will begin enrolling SLPs on June 2, 2009 CMS, and will accept (and pay for) appropriate claims submitted by enrolled SLPs for services provided on or after July 1, 2009.

Key Action Steps

  1. Initiate process to obtain NPIs if this has not already been completed.
  2. Mark June 2 on the calendar to beat the rush for enrolling the SLP’s in Medicare.
  3. Mark July 1 on the calendar date as the new effective billing date—but remember, if the SLP does not have an NPI and is not enrolled with Medicare by July 1.

 For more information, visit the most recent MLN article here.

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For more information visit www.karenzupko.com or call 312-642-5616.

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