ASHA SLPA CERTIFICATION EXAM STUDY GUIDE - PART 3 QUESTIONS AND CORRECT ANSWERS

The Medicaid Program is jointly funded by the federal and state governments to assist states in providing medical care to low-income individuals and those who are categorized as medically needy. Each state administers its own medicaid program and establishes its own income eligibility standards; type, amount, duration, and scope of services covered, and payment rates. For services to be considered medically necessary, they must be reasonable and necessary for the treatment of illness, injury, disease, disability, or developmental condition. Medical necessity is 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: - Reasonable - Necessary - Specific - Effective - Skilled Reasonable: Appropriate amount, frequency, and duration of treatment in accordance with standards of practice Necessary: Appropriate treatment for the patient's diagnosis and condition Specific: Treatment targeted to particular goals Effective: Treatment expected to yield improvement within a reasonable amount of time Skilled: 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 speech-language, hearing, balance, swallowing, voice, fluency, and cognitive-communication disorders.