Standards for Augmentative Communication Devices (E2500 – E2599)

Augmentative Communication Device: A device dedicated to transmitting or producing messages or symbols in a manner that compensates for the impairment and disability of a member with severe expressive communication disorders (e.g., communication picture books, communication charts and boards, and mechanical/electronic devices). Devices requested for the sole purpose of education will not be approved.

1. Augmentative communication devices are obtained from medical equipment and supply providers and manufacturers of augmentative communication devices.
2. Technical services, such as repairs, are covered. Bill repairs with the augmentative communication device Healthcare Common Procedure Coding System (HCPCS) code and the repair modifier (RB). Labor time (number of hours) for repairs is billed with the HCPCS labor code. Include device model number and itemized statement describing each element of the repair service.
3. Indirect time spent programming, upgrading, modifying, or setting up an augmentative communication device or communication/picture book for a member is not billable. Only direct time spent with the member is billable and documentation in the patient’s records must support the need for face-to-face involvement.

Criteria for Authorization of Augmentative Communication Devices

Refer to Equipment and Supplies for specific information about authorization criteria for Augmentative Communication Devices.

Non-Covered Services Relating to Augmentative Communication Devices

1. Augmentative communication/speech-generating devices requested for the sole purpose of education
2. Environmental control devices such as switches, control boxes, or battery interrupters
3. Modification, construction, programming, or adaptation of communication systems
4. Repairs, cleaning, or other services for devices that are not dedicated communication devices
5. Upgrading to new technology that is not proven to be medically necessary
6. Replacing devices based on the manufacturer’s recommended replacement schedule (i.e., every five years)
7. Facilitated communication: a technique by which a “facilitator” provides physical and other supports in an attempt to assist a person with a significant communication disability to point to pictures, objects, and printed works or letters (PrimeWest Health does not cover facilitated communication by any provider)
8. Personal computers, laptop computers, electronic tablets such as, iPods and iPads, and other personal media players that are not dedicated communication devices
9. Telephones
10. Carry cases when a mounting system has been provided
11. Applications, software or programs not recommended by the speech-language pathologist or that are not designated to have primary use as a communication tool
12. More than one speech-generating device funded through MHCP
13. Extended warranties
14. Wi-Fi or internet service

Augmentative Communication Device Billing Procedures^*

1. 92597: Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech
2. 92605: Evaluation for prescription of non-speech-generating augmentative and alternative communication device
3. 92606: Therapeutic service(s) for the use of non-speech-generating device, including programming and modification
4. 92607: Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour
5. 92608: Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)
6. 92609: Therapeutic services for the use of speech-generating device, including programming and modification
7. 92618: Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)

^*Refer to the speech-language pathology thresholds in this chapter for information on the number of units available without authorization.

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