Speech & Language Therapy services are medically necessary to treat speech-language, swallowing, and cognitive-communication disorders. Many of these disorders have a neurological basis such as head injury, Parkinson’s disease, stroke, autism, and cerebral palsy. Determining medical necessity takes into consideration whether a service is essential and appropriate to the diagnosis and/or treatment of an illness, injury, or disease, which Stedman’s medical dictionary (2000) defines as an “interruption, cessation, or disorder of body function.” Impaired speech and language, loss of hearing, and swallowing difficulties all reflect a loss of body functions and, therefore, services to treat such impairments meet the definition of medical necessity.

Speech & Language Therapy services must be reasonable and necessary for the treatment of illness, injury, disease, disability, or developmental condition.