There have been some exciting new developments in the domain of health care policy as it pertains to speech-language pathologists (SLPs). For a long time, we as speech pathologists have known that our work encompasses treating disorders of feeding, swallowing, speech, and language. I personally have always agreed with the American Speech and Hearing Association (ASHA) (http://www.asha.org/slp/clinical/Cognitive-Communication/) that cognitive communication disorders are within the scope of practice for SLPs. In my opinion, since language is so tightly linked to cognition (cognition is, after all, often linguistically mediated!) it seems obvious to me that treatment for cognitive communication disorders and impairments would be within the scope of practice for a speech pathologist. Unfortunately, certain insurance entities have refused to recognize cognitive communication disorders as an area to be treated by SLPs. In this regard, there has been controversy over a speech therapist’s scope of practice, particularly concerning services that insurance companies are willing to cover.
Fortunately, according to a recent ASHA newsletter article, the National Uniform Claim Committee (NUCC), “an organization that is devoted to developing, adopting, and modifying national standards for health care transactions, has adjusted its definition of what can be considered the scope of practice for SLPs, which reflects our actual scope of practice. The definition reads as follows: ‘The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairs and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.'”
Although the new NUCC terminology is not identical to that of Medicare and other health plans, it is, according to the above-mentioned article, “the only code set that can be used for HIPAA-covered transactions.” Hopefully, this will help to broaden the scope of treatment that will be covered by insurance companies.
