An AAC Evaluation and Device Delivery Are Different Billing Events

Separate the clinical work from the equipment

A speech-language pathologist can complete an excellent augmentative and alternative communication evaluation and still leave a family unsure who is obtaining the device. That confusion becomes a billing problem when the practice treats evaluation, equipment approval, delivery, and treatment as one event.

ASHA identifies 92607 and 92608 with evaluation for a speech-generating device and 92609 with therapeutic services involving its use. These clinical services are distinct from the equipment codes. Use the current code descriptions and applicable time rules rather than putting every AAC appointment under the same code. [1]

Assign responsibility for the device claim

Medicare treats qualifying speech-generating devices as durable medical equipment. ASHA's Medicare guidance explains that equipment reimbursement goes through an appropriately enrolled DME supplier and describes documentation and ordering requirements. The SLP's professional enrollment does not, by itself, establish eligibility to bill for the equipment. [1]

Before the evaluation, identify who will submit the professional claim, who will handle the equipment request, and where the family should direct questions about approval. Keep a record of what was sent and what remains outstanding. A device recommendation in your note does not tell the family whether the supplier received a complete packet.

Keep treatment tied to communication needs

Document the patient's functional communication needs, the systems considered, and the clinical reasoning behind the recommendation. For subsequent treatment, explain what the patient practiced and why skilled intervention was needed. Copying the equipment justification into every treatment note does not describe the treatment.

Commercial plans and Medicaid programs may use different supplier networks, authorization processes, or documentation requirements. Confirm those rules for the actual plan instead of presenting the Medicare pathway as universal.

The practical goal is simple: the family should leave knowing what clinical work occurred, what equipment step comes next, and who is responsible for it. An approved evaluation is not the same as an approved device.

Sources

[1] ASHA Medicare coverage policy on speech generating devices

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