Speech/Language Therapy Via Telepractice is Now Reimbursable in Virginia - Ashley Harrell (VA)

Virginia Department of Medical Assistance Services (DMAS) staff announced at the first Mid-Atlantic Telehealth Resource Center Summit in March 2012 that school based speech/language (S/L) therapy services administered via telepractice are now reimbursable through Medicaid for school district Medicaid providers. “Telepractice” as used here is the delivery by a DMAS approved speech language pathologist (SLP) of S/L therapy services through the use of videoconferencing to a child at a remote location. Telepractice was added in Virginia effective September 1, 2011, to help school districts lacking DMAS approved SLPs increase children’s access to services. DMAS reimburses school based services directly to the districts and considers telepractice as another means for delivering S/L therapy services.

In 2003, DMAS began covering statewide telemedicine for select services delivered by physicians, nurse practitioners, nurse midwives, clinical nurse specialists, clinical psychologists, clinical social workers, and licensed professional counselors. Several years ago, members of the Speech-Language-Hearing Association of Virginia and the American Speech and Hearing Association (ASHA) collaborated with the Virginia Department of Education (VDOE) and DMAS to discuss adding reimbursement for S/L therapy services when telepractice is used. In 2009, James Madison University conducted a VDOE grant funded pilot project with two Virginia local education agencies to evaluate S/L therapy services delivered by telepractice to students in public schools.

DMAS telepractice coverage includes S/L therapy services listed in the Individualized Education Program of the Medicaid or CHIP eligible child. Reimbursement covers the SLP at the remote location and a qualified school aide with the child during the telepractice session. The aide is billed as a personal care assistant under Virginia Medicaid reimbursement. Reimbursable telepractice SL therapy services are subject to DMAS requirements, such as confidentiality of information and documentation of services, and are included under the cost settlement process in Virginia. School providers are also included in the Random Moment Time Study. Equipment (costs are not reimbursable) necessary for telepractice encounters at each site include the following:

  • Two way interactive, high definition videoconferencing console with software
  • Video camera
  • Flat screen display monitor
  • Fax-copier-printer
  • Document camera, as an option
  • High speed connection with the other site

Please contact the respective state Medicaid offices for information on whether or not telepractice is covered and to what extent as data on specific state coverage is limited.