ASHA SLPA CERTIFICATION EXAM
STUDY GUIDE - PART 3 Questions and
Answers Graded A+
The Medicaid Program is - Correct answer-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; - Correct answer-type, amount, duration, and scope of
services covered, and payment rates.
For services to be considered medically necessary, they must - Correct answer-be
reasonable and necessary for the treatment of illness, injury, disease, disability, or
developmental condition.
Medical necessity is - Correct 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: - Correct answer-- Reasonable
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,- Necessary
- Specific
- Effective
- Skilled
Reasonable: - Correct answer-Appropriate amount, frequency, and duration of
treatment in accordance with standards of practice
Necessary: - Correct answer-Appropriate treatment for the patient's diagnosis and
condition
Specific: - Correct answer-Treatment targeted to particular goals
Effective: - Correct answer-Treatment expected to yield improvement within a
reasonable amount of time
Skilled: - Correct 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 - Correct answer-speech-language, hearing, balance, swallowing, voice,
fluency, and cognitive-communication disorders.
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,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 - Correct 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: - Correct
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;
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, - 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: - Correct 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:
- Correct 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
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
STUDY GUIDE - PART 3 Questions and
Answers Graded A+
The Medicaid Program is - Correct answer-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; - Correct answer-type, amount, duration, and scope of
services covered, and payment rates.
For services to be considered medically necessary, they must - Correct answer-be
reasonable and necessary for the treatment of illness, injury, disease, disability, or
developmental condition.
Medical necessity is - Correct 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: - Correct answer-- Reasonable
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,- Necessary
- Specific
- Effective
- Skilled
Reasonable: - Correct answer-Appropriate amount, frequency, and duration of
treatment in accordance with standards of practice
Necessary: - Correct answer-Appropriate treatment for the patient's diagnosis and
condition
Specific: - Correct answer-Treatment targeted to particular goals
Effective: - Correct answer-Treatment expected to yield improvement within a
reasonable amount of time
Skilled: - Correct 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 - Correct answer-speech-language, hearing, balance, swallowing, voice,
fluency, and cognitive-communication disorders.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,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 - Correct 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: - Correct
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;
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, - 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: - Correct 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:
- Correct 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
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
