National Coverage Determination (NCD)

Speech-Language Pathology Services for the Treatment of Dysphagia

170.3

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Tracking Information

Publication Number
100-3
Manual Section Number
170.3
Manual Section Title
Speech-Language Pathology Services for the Treatment of Dysphagia
Version Number
2
Effective Date of this Version
10/01/2006
Implementation Date
10/02/2006

Description Information

Benefit Category
Outpatient Speech Language Pathology Services


Please Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

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.

Indications and Limitations of Coverage

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

Cross Reference

The Medicare Benefit Policy Manual, Chapter 15, "Covered Medical and Other Health Services," §§220 and 230.3.

Claims Processing Instructions

Transmittal Information

Transmittal Number
55
Revision History

08/1989 - Covered regardless of presence of a communication disability. Effective date 08/28/1989. (TN 39)

05/2006 - Issued. Effective date: 10/01/2006. (TN 55) CR4014

Additional Information

Other Versions
Title Version Effective Between
Speech-Language Pathology Services for the Treatment of Dysphagia 2 10/01/2006 - N/A You are here
Speech Pathology Services for the Treatment of Dysphagia 1 08/28/1989 - 10/01/2006 View