Does Medicare Cover Group Therapy? Yes, current Medicare guidelines do allow for coverage of speech-language pathology services provided in group format, but (of course!) certain specific restrictions apply. The Medicare Intermediary Manual medical review guidelines for speech-language pathology (Sections 3101.10A and 3905—note that Section 3905 has been relocated to the Program Integrity Manual, Chapter 6, ... Article
Article  |   December 01, 2001
Does Medicare Cover Group Therapy?
Author Affiliations & Notes
  • Cynthia Busch
    Minnesota State University, Mankato, MN
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Article   |   December 01, 2001
Does Medicare Cover Group Therapy?
SIG 2 Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, December 2001, Vol. 11, 29. doi:10.1044/nnsld11.4.29
SIG 2 Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, December 2001, Vol. 11, 29. doi:10.1044/nnsld11.4.29
Yes, current Medicare guidelines do allow for coverage of speech-language pathology services provided in group format, but (of course!) certain specific restrictions apply. The Medicare Intermediary Manual medical review guidelines for speech-language pathology (Sections 3101.10A and 3905—note that Section 3905 has been relocated to the Program Integrity Manual, Chapter 6, Section 6) was last revised by the Health Care Financing Administration (HCFA) in 1991 and has minimal wordage related to group treatment. (Note that HCFA has been renamed the Centers for Medicare and Medicaid Services, i.e., CMS). The only formal reference to coverage of group therapy states: “Generally, group therapy treatment and attendance at social or support groups, such as stroke clubs or lost cord clubs, are not payable. Ensure that the reasonable and necessary requirements are met.”
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