Is speech therapy covered by insurance blue cross blue shield

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Land acknowledgement
Does BCBS of NC cover speech therapy?
Is speech therapy covered by insurance in USA?
Is speech therapy covered by Medi Cal?
What can be billed under 92507?

Land acknowledgement

We begin by acknowledging that we are on traditional lands, referred to as Treaty 6, Treaty 7 and Treaty 8 territory, and all the people here are beneficiaries of these peace and friendship treaties.

This territory is the home for many Indigenous Peoples, including the Blackfoot, Cree, Dene, Saulteaux, Ojibwe, Stoney Nakota Sioux, and Tsuut’ina peoples, and the Métis Nation of Alberta and the Métis Settlements.

We respect the Treaties that were made on these territories, we acknowledge the harms and mistakes of the past, and we dedicate ourselves to moving forward in partnership with Indigenous communities in a spirit of reconciliation and collaboration.

©Copyright 2022 ABC Benefits Corporation. All rights reserved. ®* The Blue Cross® symbol and name are registered marks of the Canadian Association of Blue Cross Plans®, an association of independent Blue Cross® plans. Licensed to ABC Benefits Corporation for use in operating the Alberta Blue Cross Plan®. ®† Blue Shield is a registered trade-mark of the Blue Cross Blue Shield Association.

Ambulance services An OK from us is not needed for emergency ambulance transport

A licensed ambulance company
An emergency

Audiology services No The Texas Health Steps program gives audiology services and hearing aids for ages 0 through 20 Chiropractic services You do not need an OK from us to see a chiropractor in your network Covers services that help keep the spine and other body structures straight Community First Choice services Yes For those members who qualify for these services. The state provides an array of services to members who would otherwise qualify for care in a nursing facility, an ICF/IDD, or an institution for mental diseases (IMD).

Personal Care Services - CFC - All qualified members may receive medically and functionally necessary Personal Assistance Services under CFC.
Acquisition, maintenance and enhancement of skills - All qualified members may receive this service to enable the member to accomplish ADLs, IADLs and health-related tasks.
Emergency Response Services - CFC - (Emergency call button) - All qualified members may receive necessary emergency response services under CFC.
Support Management - All qualified members may receive voluntary training on how to select, manage and dismiss attendants.

Diagnostic and therapeutic radiology Some radiology services need an OK from us before you get the service. These include CT, MRI, MRA, PET and SPECT Testing and X-rays that are:

not invasive
done to find out what is wrong
ordered and done by (or under the guidance of) your provider

Doctor services No

Visits to doctors, specialists or other providers
Well exams

Durable Medical Equipment(DME) and disposable supplies Yes

Medical equipment given for use in the home
Medically necessary
Within the limits of what is covered by Medicaid

Emergency services No

Emergency room
Ambulance services

Family planning No

Medical visits for birth control
Marriage and family planning, education and counseling services
Birth control medications, including long acting reproductive contraception (LARC)

Home health services Yes

Nursing services
Personal care services

Inpatient hospital services Yes

Hospital room with two or more beds
Nursing care
Operating room
Surgery
Anesthesia

Lab services Yes All authorized lab services Medically Dependent Children Program (MDCP) STAR Kids Yes The following is a list of covered services for members who qualify for MDCP STAR Kids services. BCBSTX must provide medically and functionally necessary services to members who meet the functional and financial eligibility for MDCPSTAR Kids.

Respite Care;
Supported Employment;
Financial Management Services;
Adaptive Aids;
Employment Assistance;
Flexible Family Support Services;
Minor home modifications; and
Transition Assistance Services.

OB/GYN services No

Care that has to do with pregnancy
Care for any female medical condition
One well-woman checkup per year

Orthotics and prosthetics Sometimes needs an OK from us Parts needed such as man-made arms or legs and the parts needed to attach them

Orthotic braces, splints or ankle and foot supports
Covered when medically necessary

Outpatient hospital services Yes

Dialysis
Giving you someone else’s blood

Physical, Occupational and Speech Therapy Sometimes needs an OK from us These services are covered when ordered by a doctor and are part of a written plan of care Podiatry No Covered services include:

Medical problems of the feet
Medical or surgical treatment of disease, injury or defects of the foot

Pregnancy and maternity care No

Pregnancy
After-delivery care when medically necessary
Newborn exams

Prescription Drugs Some drugs including brand name drugs need an OK from BCBSTX

BCBSTX uses Medicaid/CHIP Vendor Drug Program's (VDP) preferred drug list
Most generic and over-the-counter drugs are covered

Therapies Sometimes needs an OK from us

Developmental assessments
Physical, occupational or speech therapy

Texas Health Steps Medical Checkups No

Routine shots
Lab tests
Comprehensive Care Program services for members 20 years and under
DME
Home health and other medically necessary services

Transplant Yes

Human organ and tissue transplants that are not still being tested
All corneal, bone marrow and peripheral stem cell transplants that are not still being tested

Vision Services No An eye exam every 12 months

Does BCBS of NC cover speech therapy?

Speech therapy is covered when services are directed toward treatment of a specific disease, injury or congenital anomaly and services are expected to result in a significant and measurable improvement in functional capabilities within a reasonable and defined period of time.

Is speech therapy covered by insurance in USA?

Typically, the American Speech-Language-Hearing Association recommends insurance cover 20% of your child's therapy cost. This means, for a typical year of therapy, you can expect to pay anywhere from $4,000-$6,000 out of pocket.

Is speech therapy covered by Medi Cal?

Medi-Cal covers speech therapy services only when ordered on the written referral of a physician or dentist. (CCR, Title 22, Section 51309[a].) Providers should verify the recipient's Medi-Cal eligibility for the month of service.

What can be billed under 92507?

Use 92507 for training and modification of voice prostheses. Medicare won't pay for this code because it is considered bundled with any other speech-language pathology service provided on the same day. SLPs may not separately bill for non-speech-generating device services alone.