Decision Memorandum and Revised Scope of Benefit National Coverage Determination for Speech Generating Devices
The Centers for Medicare & Medicaid Services (CMS) today posted a final decision memorandum related to coverage of speech generating devices. Speech generating devices are considered to fall within the Medicare durable medical equipment (DME) benefit category. The current national coverage determination (NCD) for speech generating devices was established in 2001 and covers devices that generate speech for patients with a severe speech impairment. The 2001 NCD limits coverage to devices that are not capable of performing functions other than generating speech. Software that generates speech and is used on a laptop computer, tablet, or other non-DME device is also covered under the NCD implemented in 2001, but the device the software is used on is not covered.
In November of last year, CMS posted an NCD tracking sheet indicating plans to reconsider the current NCD and received 2,290 comments from the public on this topic. These comments were considered in developing the proposed NCD issued on April 29, 2015, which addressed a number of concerns raised by stakeholders by allowing Medicare coverage of devices that include a broader range of functionality (e.g., the capability to send text or email messages considered to be forms of speech), and no longer have to be dedicated to only generating speech as long as the device is used solely by the individual with a speech impairment and is primarily used for the purpose of generating speech. CMS received 226 comments on the proposed NCD, most in support of the proposed NCD.
The final NCD
The final NCD incorporated some suggestions from the public on revisions to certain language in the proposed NCD, but the major provisions of the proposed NCD are being finalized as proposed. Under the new NCD, devices that generate speech will still be considered DME even though they can perform other functions as long as they are used solely by the patient with the severe speech impairment and are used primarily for the generation of speech. In addition, the capability of the device to generate other forms of speech such as phone, email, and text messages would be covered under the DMD benefit. The final decision memorandum is located at:
Timeline
November 6, 2014 CMS opens a benefit category determination NCD process and 30-day public comment period on tracking sheet and general issue begins.
December 6, 2014 End of public comment period for tracking sheet. CMS received 2,290 comments.
April 29, 2015 Proposed decision memorandum issued and 30-day public comment period on the proposed NCD began.
May 29, 2015 Comment period closed.
July 29, 2015 Final decision memorandum issued 60 days following the close of the comment period.
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