CurrentCapital BluecrossPolicy MP 8.002
SPEECH THERAPY (OUTPATIENT)
Defines medical necessity criteria, investigational exclusions, documentation requirements, coding notes, and product variations for outpatient speech therapy services (Policy MP 8.002) administered by Capital Blue Cross.
Policy Summary
PayerCapital Bluecross
PolicySPEECH THERAPY (OUTPATIENT)
Policy CodePolicy MP 8.002
Change TypeConsensus/Administrative reviews (coding and references updates)
Effective Date12/01/2025
Next Review Date
Key ActionProviders must document patient's history, diagnoses requiring speech therapy, attending physician and orders, therapy goals with measurable objectives and expected timeframe, contraindications, patient understanding, specific treatment type/amount/frequency/duration, and summary/results of prior therapy when appropriate.
POLICY UPDATE CHANGES
09/28/2023 Minor Review updated both covered and noncovered conditions and added policy guideline section with table of language disorders and CPT codes.
08/09/2024 Consensus Review added CPT code 96112.
07/31/2025 Consensus Review updated references; no change to policy stance.
10/30/2025 Administrative Update removed Benefit Variations Section and updated Disclaimer.
10Example covered indications listed
4Investigational / not covered items listed
5CPT/HCPCS codes explicitly cited
5