Determining Which Speech-Language Credentialed Providers Require Supervision to Bill Under the California LEA Billing Option Program

Following the approval of California State Plan Amendment (SPA) 05-010, supervision is no longer required for Local Education Agency (LEA) providers holding a preliminary or professional clear credential in speech-language pathology to bill eligible assessments and treatments under the LEA Billing Option program. This guide is intended to help LEA coordinators determine how SPA 05-010 will affect providers in their districts who may carry a wide range of credentials related to speech, hearing, and audiology.

 

SPA 05-010: Establishing Equivalency for Certain SLP Credentials

In December 2011, the California Department of Health Care Services (DHCS) received long-awaited approval for SPA 05-010, an amendment to California’s State Plan that incorporates equivalency for preliminary and professional clear credentials in speech-language pathology (SLP) according to the federal standards governing Medicaid reimbursement.

As a result of this amendment to California’s state Medicaid plan, LEA providers who hold a preliminary or professional clear services credential in speech-language pathology can now bill for both assessments and treatments without supervision from a licensed speech-language pathologist under the LEA Billing Option program.

It is important to note that all other state and federal requirements governing these providers, such as recommendations, referrals, and speech protocol, still apply.

 

Speech-Language Pathology Credential Matrix

The following chart is intended to help guide program coordinators in identifying which providers no longer require supervision to bill eligible assessments and treatments under the LEA Billing Option program.

SLP Matrix 2012

Additional Resources

DHCS is expected to issue additional guidelines following the passage of SPA 05-010, including important information on how LEAs can obtain reimbursements for such services that have aged more than one year (the effective date for the new policy in the SPA is listed as October 2009). In the meantime, the following resources may prove helpful:

    1. Upgrade a Clinical or Rehabilitative Services credential to a Speech-Language Pathology Services credential (preliminary or professional clear), provided by the State of California Commission on Teacher Credentialing: http://www.ctc.ca.gov/credentials/leaflets/cl610.pdf
    2. Detailed information on Speech-Language Pathology Services credentials, provided by the State of California Commission on Teacher Credentialing: http://www.ctc.ca.gov/credentials/CREDS/speech-lang-path.html
    3. California Attorney General’s opinion that a state services credential with a specialization in Clinical or Rehabilitative Services does not qualify the holder as a “speech pathologist” under federal standards governing Medicaid reimbursement: http://ag.ca.gov/opinions/pdfs/06-104.pdf
    4. Check your credential type or the credential types of your providers: http://www.ctc.ca.gov/lookup.html