ASHA SLPA CERTIFICATION EXAM STUDY GUIDE - PART 3 Questions and 100% Correct Answers
A "qualified audiologist" means an individual with a master's or doctoral degree in audiology that
maintains documentation to demonstrate that he or she meets one of the following conditions: -
Answer-i. The State in which the individual furnishes audiology services meets or exceeds State licensure
requirements in paragraph, and the individual is licensed by the State as an audiologist to furnish
audiology services.
ii. Have a Certificate of Clinical Competence in Audiology granted by the American Speech-Language-
Hearing Association.
A. Have successfully completed a minimum of 350 clock-hours of supervised clinical practicum (or is in
the process of accumulating that supervised clinical experience under the supervision of a qualified
master or doctoral-level audiologist); performed at least 9 months of full-time audiology services under
the supervision of a qualified master or doctoral degree in audiology, or a related field; and successfully
completed a national examination in audiology approved by the Secretary.
A "speech pathologist" is an individual who meets one of the following conditions: - Answer-i. Has a
certificate of clinical competence from the American Speech and Hearing Association
ii. Has completed the equivalent educational requirements and work experience necessary for the
certificate
iii. Has completed the academic program and is acquiring supervised work experience to qualify for the
certificate
A service must be specifically identified in the state's Medicaid plan, or be furnished under the Early,
Periodic, Screening, Diagnosis, and Treatment (EPSDT) benefit, - Answer-to make Medicaid payment
permissible.
A speech-language pathologist must keep in mind that participation in the Medicaid reimbursement
program places him/her in a - Answer-fiduciary position; that is, the speech-language pathologist is
entrusted by the government to provide quality services and/or supervision of services and to bill
appropriately for those services in accordance with Medicaid regulations.
,According to the School-Based Administrative Claiming Guide, - Answer-if the screening leads to a child
being identified as having a disability under the IDEA and the development of an IEP, Medicaid could pay
for services provided in the IEP.
Advocacy activities regarding telepractice may target specific issues unique to a particular state -
Answer-- Some states may require special Medicaid approval for the practitioner to be a telepractice
provider.
- Some states may limit telepractice coverage to specified rural areas.
- More states are expanding telepractice coverage through legislation that mandates insurance
reimbursement for telepractice services.
- Some state Medicaid regulations have leveraged legislation in order to broaden coverage by private
insurers.
- Legislative language typically specifies that, if a service is reimbursed by insurance, that same service
should be covered when provided via telepractice.
Advocate for CFs to become Medicaid providers in all settings to ensure that - Answer-- there will be an
adequate number of providers, and
- the state can meet the need for additional providers that may result from Medicaid expansion or
general increase in Medicaid roles.
Affordable Care Act (ACT) - Answer-expands access to health care for almost 30 million Americans and
strengthens existing protections for consumers in the health insurance market.
Although each state established a state plan, including specific requirements, relevant documentation
for establishing medical necessity may include: - Answer-- medical history, such as pertinent medical
history, brief description of functional status, and relevant prior treatment;
- diagnosed speech, language, swallowing, hearing, or balance disorder;
- identification of a child with a disability as eligible for services under the Individuals with Disabilities
Education Act (IDEA) or determination by an IEP team that services are required;
- date of onset;
- physician referral, if required (reauthorization may be required);
,- initial assessment and date - the procedure(s) used by the audiologist or SLP to diagnose a speech,
language, voice, fluency, cognitive-communication, swallowing, hearing, or balance disorder and the
date the initial assessment is completed;
- plan of treatment or a treatment program and date established; and
- progress notes and/or reports
An interagency agreement, which describes and defines - Answer-the relationships between the state
Medicaid agency, the state department of education, and/or the school district or local entity
conducting the activities must be in place in order to claim federal matching funds.
Are schools required to bill Medicaid? - Answer-No. School participation in Medicaid reimbursement for
certain health related services is one of the optional Medicaid programs available to states. Billing and
reimbursement procedures are guided by the State Medicaid Plan. This agreement defines the
relationship between the State Medicaid agency and the school district. School districts who choose to
participate in Medicaid reimbursement programs are considered the "provider" of the health related
services.
ASHA recommends that, at a minimum, supervisees - Answer-(1) hold a standard state education license
or certificate in speech-language disorders, (2) be a graduate student intern participating in an ASHA
accredited graduate program and receiving supervision in accordance with the supervision requirements
of the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA), (3) be an
undergraduate intern participating in an undergraduate program in communication disorders and
receiving supervision equivalent to the supervision requirements of the CAA, or (4) be a speech-
language pathology assistant supervised according to ASHA guidelines. This standard excludes persons
with emergency credentials from a state department of education and paraprofessionals other than
speech-language pathology assistants.
Audiologists and speech-language pathologists may work with state associations to address concerns
related to: - Answer-- establishing temporary or provisional licensure for those completing clinical
fellowship to enable these practitioners to bill Medicaid directly-in many states, this requires a statutory
change of state licensure;
- regulating speech-language pathology assistants (SLPAs) and audiology assistants to ensure adequate
services for Medicaid beneficiaries-approximately 50% of the states currently license or otherwise
regulate SLPS
, - providing supervisors with adequate training in supervision and sufficient time to conduct observations
of and provide support to supervisees.
Audiology and speech-language pathology services are medically necessary to treat - Answer-speech-
language, hearing, balance, swallowing, voice, fluency, and cognitive-communication disorders.
Because CMS will no longer cover CPT 96110 Developmental screen, - Answer-this supplemental G code,
which is valued on the previously-published values of CPT code 96110, was added as a temporary code.
Medicaid and private payers may sometimes, but not always, follow suit. There is no guarantee of
continued reimbursement, but G0451 may be an alternative to 96110. Because of the potential for
confusion with these codes, documentation should be very clear.
Best practice standards recommend that states require that audiologists and speech-language
pathologists - Answer-meet the requirements stated in the Federal Register, Title 42, addressing the
Certificate of Clinical Competence (CCC), Clinical Fellowship (CF), and/or state licensure.
Can an audiologist or speech-language pathologist provide and bill for school-based services? - Answer-
Yes. Both schools and individual practitioners within schools may be certified as Medicaid providers if
they meet state provider qualifications.
School districts sign a provider agreement that enrolls it with the State's Medicaid program. The
agreement establishes the rate of payment, the protocol for submission of bills, privacy issues and other
details. States may establish liaisons between State Medicaid programs and educational agencies.
For individual practitioners, Federal Medicaid regulations state that a speech-language pathologist or
audiologist is an individual who,
1. has a certificate of clinical competence from ASHA
2. has completed the equivalent educational requirements and work experience necessary for the
certificate; or
3. has completed the academic program and is acquiring supervised work experience to qualify for the
certificate.
A "qualified audiologist" means an individual with a master's or doctoral degree in audiology that
maintains documentation to demonstrate that he or she meets one of the following conditions: -
Answer-i. The State in which the individual furnishes audiology services meets or exceeds State licensure
requirements in paragraph, and the individual is licensed by the State as an audiologist to furnish
audiology services.
ii. Have a Certificate of Clinical Competence in Audiology granted by the American Speech-Language-
Hearing Association.
A. Have successfully completed a minimum of 350 clock-hours of supervised clinical practicum (or is in
the process of accumulating that supervised clinical experience under the supervision of a qualified
master or doctoral-level audiologist); performed at least 9 months of full-time audiology services under
the supervision of a qualified master or doctoral degree in audiology, or a related field; and successfully
completed a national examination in audiology approved by the Secretary.
A "speech pathologist" is an individual who meets one of the following conditions: - Answer-i. Has a
certificate of clinical competence from the American Speech and Hearing Association
ii. Has completed the equivalent educational requirements and work experience necessary for the
certificate
iii. Has completed the academic program and is acquiring supervised work experience to qualify for the
certificate
A service must be specifically identified in the state's Medicaid plan, or be furnished under the Early,
Periodic, Screening, Diagnosis, and Treatment (EPSDT) benefit, - Answer-to make Medicaid payment
permissible.
A speech-language pathologist must keep in mind that participation in the Medicaid reimbursement
program places him/her in a - Answer-fiduciary position; that is, the speech-language pathologist is
entrusted by the government to provide quality services and/or supervision of services and to bill
appropriately for those services in accordance with Medicaid regulations.
,According to the School-Based Administrative Claiming Guide, - Answer-if the screening leads to a child
being identified as having a disability under the IDEA and the development of an IEP, Medicaid could pay
for services provided in the IEP.
Advocacy activities regarding telepractice may target specific issues unique to a particular state -
Answer-- Some states may require special Medicaid approval for the practitioner to be a telepractice
provider.
- Some states may limit telepractice coverage to specified rural areas.
- More states are expanding telepractice coverage through legislation that mandates insurance
reimbursement for telepractice services.
- Some state Medicaid regulations have leveraged legislation in order to broaden coverage by private
insurers.
- Legislative language typically specifies that, if a service is reimbursed by insurance, that same service
should be covered when provided via telepractice.
Advocate for CFs to become Medicaid providers in all settings to ensure that - Answer-- there will be an
adequate number of providers, and
- the state can meet the need for additional providers that may result from Medicaid expansion or
general increase in Medicaid roles.
Affordable Care Act (ACT) - Answer-expands access to health care for almost 30 million Americans and
strengthens existing protections for consumers in the health insurance market.
Although each state established a state plan, including specific requirements, relevant documentation
for establishing medical necessity may include: - Answer-- medical history, such as pertinent medical
history, brief description of functional status, and relevant prior treatment;
- diagnosed speech, language, swallowing, hearing, or balance disorder;
- identification of a child with a disability as eligible for services under the Individuals with Disabilities
Education Act (IDEA) or determination by an IEP team that services are required;
- date of onset;
- physician referral, if required (reauthorization may be required);
,- initial assessment and date - the procedure(s) used by the audiologist or SLP to diagnose a speech,
language, voice, fluency, cognitive-communication, swallowing, hearing, or balance disorder and the
date the initial assessment is completed;
- plan of treatment or a treatment program and date established; and
- progress notes and/or reports
An interagency agreement, which describes and defines - Answer-the relationships between the state
Medicaid agency, the state department of education, and/or the school district or local entity
conducting the activities must be in place in order to claim federal matching funds.
Are schools required to bill Medicaid? - Answer-No. School participation in Medicaid reimbursement for
certain health related services is one of the optional Medicaid programs available to states. Billing and
reimbursement procedures are guided by the State Medicaid Plan. This agreement defines the
relationship between the State Medicaid agency and the school district. School districts who choose to
participate in Medicaid reimbursement programs are considered the "provider" of the health related
services.
ASHA recommends that, at a minimum, supervisees - Answer-(1) hold a standard state education license
or certificate in speech-language disorders, (2) be a graduate student intern participating in an ASHA
accredited graduate program and receiving supervision in accordance with the supervision requirements
of the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA), (3) be an
undergraduate intern participating in an undergraduate program in communication disorders and
receiving supervision equivalent to the supervision requirements of the CAA, or (4) be a speech-
language pathology assistant supervised according to ASHA guidelines. This standard excludes persons
with emergency credentials from a state department of education and paraprofessionals other than
speech-language pathology assistants.
Audiologists and speech-language pathologists may work with state associations to address concerns
related to: - Answer-- establishing temporary or provisional licensure for those completing clinical
fellowship to enable these practitioners to bill Medicaid directly-in many states, this requires a statutory
change of state licensure;
- regulating speech-language pathology assistants (SLPAs) and audiology assistants to ensure adequate
services for Medicaid beneficiaries-approximately 50% of the states currently license or otherwise
regulate SLPS
, - providing supervisors with adequate training in supervision and sufficient time to conduct observations
of and provide support to supervisees.
Audiology and speech-language pathology services are medically necessary to treat - Answer-speech-
language, hearing, balance, swallowing, voice, fluency, and cognitive-communication disorders.
Because CMS will no longer cover CPT 96110 Developmental screen, - Answer-this supplemental G code,
which is valued on the previously-published values of CPT code 96110, was added as a temporary code.
Medicaid and private payers may sometimes, but not always, follow suit. There is no guarantee of
continued reimbursement, but G0451 may be an alternative to 96110. Because of the potential for
confusion with these codes, documentation should be very clear.
Best practice standards recommend that states require that audiologists and speech-language
pathologists - Answer-meet the requirements stated in the Federal Register, Title 42, addressing the
Certificate of Clinical Competence (CCC), Clinical Fellowship (CF), and/or state licensure.
Can an audiologist or speech-language pathologist provide and bill for school-based services? - Answer-
Yes. Both schools and individual practitioners within schools may be certified as Medicaid providers if
they meet state provider qualifications.
School districts sign a provider agreement that enrolls it with the State's Medicaid program. The
agreement establishes the rate of payment, the protocol for submission of bills, privacy issues and other
details. States may establish liaisons between State Medicaid programs and educational agencies.
For individual practitioners, Federal Medicaid regulations state that a speech-language pathologist or
audiologist is an individual who,
1. has a certificate of clinical competence from ASHA
2. has completed the equivalent educational requirements and work experience necessary for the
certificate; or
3. has completed the academic program and is acquiring supervised work experience to qualify for the
certificate.
