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Speech Therapy for Feeding and Swallowing Disorders

April 13, 2017

As of June 1, 2017, CFHP will implement a speech therapy policy.

Initial evaluation requests must be pre-authorized and must be submitted by the PCP and include:

  • Signed physician order
  • Clinical notes documenting feeding/swallowing problems
  • Early Childhood Intervention (ECI) referral (for members under 3 years)

Initial therapy may be approved for a maximum of 90 days with a frequency of 2X/week. Therapy may be approved for 3X/week by the medical director if the severity of the dysphagia warrants. A re-evaluation will be included in this authorization.

Initial therapy requests/re-evaluations must include:

  • Signed physician order
  • Evaluation and Plan of Care that includes:
    • Physician signature
    • Referring provider’s diagnosis and reason for referral
    • Brief statement of member’s medical history and any prior treatment history
    • Current level of functioning or impairment
    • Clear diagnosis and reasonable prognosis
    • Treatment modalities, frequency and duration
    • Short and long term treatment goals
    • Home exercise program
    • Plan for collaboration with ECI/Head Start/SHARS when applicable
    • Clearly established dc plan
  • Documentation of a completed medical evaluation

Please contact Donna Glassman at 210-358-6121 for additional information regarding the policy in full.