CurrentKaiser PermanentePolicy N/A

Clinical Review Criteria — Speech Generating Devices (Augmentative and Alternative Communication Devices)

Clinical review criteria governing medical necessity determinations for augmentative and alternative communication (AAC) devices and accessories for Kaiser Foundation Health Plan of Washington members; applies to providers requesting authorization for these devices.

Policy Summary

PayerKaiser Permanente

PolicyClinical Review Criteria — Speech Generating Devices

Policy CodePolicy N/A

Change TypeCodes updatedCPT removed

Effective DateN/A

Next Review DateFeb 13, 2024

Key ActionObtain pre-authorization for listed HCPCS device and accessory codes and submit the last 6 months of clinical notes and speech therapy notes to support medical necessity.

SourceLink

POLICY UPDATE CHANGES

Removed CPT 92609 from criteria page as this code is for the service and not the device.

Updated applicable codes.

Use of MCG Augmentative Communication Devices, Electronic (KP-0516) guideline for non-Medicare members' medical necessity determinations.

~15HCPCS device and accessory codes listed

43Articles cited in MTAC review

No RCTsRandomized controlled trials

6+Recommended clinical notes timeframe (months)

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Coverage / Medical Necessity Criteria

Medically Necessary Criteria

Considered medically necessary when criteria in the applicable policy statements or referenced MCG guideline are met.

Medically Necessary: Device or accessory is listed (HCPCS E1902, E2500–E2513, E2599) AND medical necessity is demonstrated per the applicable policy statements or the MCG Augmentative Communication Devices, Electronic (KP-0516) guideline for non-Medicare members.

Providers must supply supporting documentation and verify authorization requirements by plan; MCG criteria may be requested for individual cases.

The Medical Technology Assessment Committee (MTAC) review found significant limitations in the available literature on augmentative and alternative communication (AAC) devices. The published evidence base is small and heterogeneous: the search returned 43 articles that were primarily reviews, tutorials, notes, and discussions, with only a few primary studies. No randomized controlled trials or meta-analyses were identified, and most reports were descriptive or observational in design. MTAC concluded that the existing studies did not provide sufficient evidence to determine the effect of AAC devices on the communication skills of children with speech impairments.

MTAC noted that the available primary studies had methodological weaknesses: small sample sizes, absence of control groups, reliance on subjective outcome measures (for example, patient or parent satisfaction), and risk of selection and observation bias. The committee identified only four case reports and two small studies measuring satisfaction or utilization; no randomized controlled trials were found. These limitations underpin the policy’s characterization of the clinical evidence as limited and primarily composed of case reports and subjective measures.

HCPCS / Device Coding

Covered HCPCS CodesHCPCSCovered

E1902	Communication board, nonelectronic augmentative or alternative communication device.
E2500	Speech generating device, digitized speech, using prerecorded messages, less than or equal to eight minutes recording time.
E2502	Speech generating device, digitized speech, using prerecorded messages, greater than eight minutes but less than or equal to 20 minutes recording time.
E2504	Speech generating device, digitized speech, using prerecorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time.
E2506	Speech generating device, digitized speech, using prerecorded messages, greater than 40 minutes recording time.
E2508	Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device.
E2510	Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access.
E2511	Speech generating software program, for personal computer or personal digital assistant.
E2512	Accessory for speech generating device, mounting system.
E2513	Accessory for speech generating device, electromyographic sensor.

1–10 of 11

1/2

Provider Requirements and Authorization

Prior Authorization

Prior Authorization Required

Pre-authorization is required for the listed HCPCS device and accessory codes; verify authorization requirements by plan using the Pre-authorization Code Check.

Use Pre-authorization Code Check to confirm requirements by plan type

Note

MCG Guideline Use

Kaiser Permanente uses the MCG guideline 'Augmentative Communication Devices, Electronic (KP-0516)' for medical necessity determinations for non‑Medicare members. MCG guidelines are proprietary and cannot be published; however, providers may request the specific MCG criteria used for an individual utilization management decision by contacting Kaiser Permanente Clinical Review staff at 1-800-289-1363 or via the provider portal MCG Guideline Index.

Documentation Required

Key Definitions

Symbols, aids, techniques, and strategies — definitions of AAC components

AAC componentsAAC has four components: symbols, aids, techniques, and strategies.

Definition of 'aids'Aids are the physical objects or devices used to transmit or receive messages (examples: books, communication boards, charts, mechanical or electronic devices, and computers).

Role of aidsAids vary in capability, durability, and cost and are adapted as an individual's abilities change over time.

HCPCS codes E2500–E2513 and E2599 — device and accessory descriptions

E2500Speech generating device, digitized speech, using prerecorded messages, less than or equal to eight minutes recording time.

E2502Speech generating device, digitized speech, using prerecorded messages, greater than eight minutes but less than or equal to 20 minutes recording time.

Background and Clinical Context

Augmentative and alternative communication (AAC) is intended to temporarily or permanently compensate for severe oral or written expressive communication disorders. AAC systems combine symbols, aids, techniques, and strategies and may include existing speech, gestures, sign language, communication boards, and electronic devices. Devices and systems should be tailored to the user and updated as abilities change, and multidisciplinary coordination is important—particularly for children with congenital or acquired language disorders—so AAC can be integrated into therapy, education, and daily communication environments.

Policy Changes and Revision Notes

Summary of policy updates: the codes list was revised (applicable codes updated) and, to clarify billing scope, CPT 92609 was removed from the criteria page because it describes a service rather than a device. The policy also documents that the MCG guideline (KP-0516) is used for non‑Medicare member medical necessity determinations and may be referenced when making decisions. These updates are reflected in the policy’s revision history.

2026-02-03reviewLatest

Policy reviewed (MPC) on 2026-02-03.

2025-09-25codes_updated

Updated applicable codes.