ASHA SLPA CERTIFICATION EXAM EXAM PREP
2026 PRACTICE SOLUTION STUDY GUIDE
◉ Each state administers its own medicaid program and establishes
its own income eligibility standards; Answer: type, amount,
duration, and scope of services covered, and payment rates.
◉ For services to be considered medically necessary, they must
Answer: be reasonable and necessary for the treatment of illness,
injury, disease, disability, or developmental condition.
◉ Medical necessity is Answer: a critical factor for determining
eligibility for Medicaid-reimbursable therapy and treatment
services.
◉ Medicaid claims may be supported when providers document the
following basic elements: Answer: - Reasonable
- Necessary
- Specific
- Effective
- Skilled
,◉ Reasonable: Answer: Appropriate amount, frequency, and
duration of treatment in accordance with standards of practice
◉ Necessary: Answer: Appropriate treatment for the patient's
diagnosis and condition
◉ Specific: Answer: Treatment targeted to particular goals
◉ Effective: Answer: Treatment expected to yield improvement
within a reasonable amount of time
◉ Skilled: Answer: Treatment requiring the knowledge, skills, and
judgement of a speech-language pathologist (SLP) or audiologist
◉ Audiology and speech-language pathology services are medically
necessary to treat Answer: speech-language, hearing, balance,
swallowing, voice, fluency, and cognitive-communication disorders.
◉ Children who require services as part of their individualized
education programs (IEPs) and are identified as having a disability
under the Individuals with Disabilities Education Act (IDEA) are
Answer: also generally considered to have met the requirements for
services to be medically necessary.
,◉ 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
◉ Professionals may work with their state association leadership,
local education agencies, state education agencies, and state
Medicaid offices to address specific topics or questions. Successful
efforts to improve efficiency for professionals in some states include:
Answer: - streamlining paperwork;
, - establishing evaluation or IEP by a qualified professional as
adequate to establish medical necessity and eliminating need for
physician signature
- expediting physician referral and examination process;
- clarifying medical necessity criteria and documentation
requirements;
- updating states policy and procedure information
- advocating for services not covered (i.e., private practice and
telepractice)
◉ 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 "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.
2026 PRACTICE SOLUTION STUDY GUIDE
◉ Each state administers its own medicaid program and establishes
its own income eligibility standards; Answer: type, amount,
duration, and scope of services covered, and payment rates.
◉ For services to be considered medically necessary, they must
Answer: be reasonable and necessary for the treatment of illness,
injury, disease, disability, or developmental condition.
◉ Medical necessity is Answer: a critical factor for determining
eligibility for Medicaid-reimbursable therapy and treatment
services.
◉ Medicaid claims may be supported when providers document the
following basic elements: Answer: - Reasonable
- Necessary
- Specific
- Effective
- Skilled
,◉ Reasonable: Answer: Appropriate amount, frequency, and
duration of treatment in accordance with standards of practice
◉ Necessary: Answer: Appropriate treatment for the patient's
diagnosis and condition
◉ Specific: Answer: Treatment targeted to particular goals
◉ Effective: Answer: Treatment expected to yield improvement
within a reasonable amount of time
◉ Skilled: Answer: Treatment requiring the knowledge, skills, and
judgement of a speech-language pathologist (SLP) or audiologist
◉ Audiology and speech-language pathology services are medically
necessary to treat Answer: speech-language, hearing, balance,
swallowing, voice, fluency, and cognitive-communication disorders.
◉ Children who require services as part of their individualized
education programs (IEPs) and are identified as having a disability
under the Individuals with Disabilities Education Act (IDEA) are
Answer: also generally considered to have met the requirements for
services to be medically necessary.
,◉ 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
◉ Professionals may work with their state association leadership,
local education agencies, state education agencies, and state
Medicaid offices to address specific topics or questions. Successful
efforts to improve efficiency for professionals in some states include:
Answer: - streamlining paperwork;
, - establishing evaluation or IEP by a qualified professional as
adequate to establish medical necessity and eliminating need for
physician signature
- expediting physician referral and examination process;
- clarifying medical necessity criteria and documentation
requirements;
- updating states policy and procedure information
- advocating for services not covered (i.e., private practice and
telepractice)
◉ 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 "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.
