Eli's Rehab Report

Published on Tue Jul 26, 2011 PDF

But don't apply the change across the board.

There's good news for speech-language pathologists (SLPs) performing certain endoscopic procedures: Soon you will no longer need physician supervision. As of Jan. 1, the Centers for Medicare and Medicaid Services ruled that SLPs performing videostroboscopy (31579) or nasopharyngoscopy (92511) must be supervised by a physician.

Problem: While physicians do perform the diagnostic procedures, they aren't the only ones. SLPs also perform them to evaluate and treat a patient's functional/use problems. Requiring an SLP to be supervised would severely limit the SLPs ability to perform the job functions they are trained and well-equipped to do.

Solution: CMS is removing the requirement effective October 1, according to a letter from CMS administrator Donald Berwick.

Not so fast: Though Berwick's letter removes all supervision levels assigned to the two procedures, individual Medicare administrative contractors may establish local supervision requirements for videostroboscopy and nasopharyngoscopy in their local coverage determinations, points out the American Speech-Language-Hearing Association (ASHA).

This decision also doesn't affect fiberoptic endoscopic examination of swallowing (FEES) or other endoscopy procedures, ASHA notes.