N.J. Admin. Code § 10:59-1.13

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:59-1.13 - Augmentative/alternative communication system (ACS)

(a) ACS requires prior authorization. Requests for prior authorization shall include the following:

1. A list of specialists involved in the multi-disciplinary team evaluation of the beneficiary, including, at a minimum, a speech-language pathologist, physical therapist, occupational therapist, and social worker.

2. An evaluation report by the speech-language pathologist, which shall include the following:

i. The communication status of the beneficiary, including relevant mental and physical disabilities;

ii. A list of augmentative/alternative communication devices/systems tried during the evaluation period;

iii. The rationale for the selection of the prescribed device/system and a description of how it will enhance functional communicative abilities;

iv. A certification that the beneficiary can mentally and physically benefit from the device/system and is willing to use it;

v. Recommendations for follow-up instruction so that maximum benefit may be obtained;

vi. A description of the beneficiary's gross and fine motor abilities, perceptual skills, reading skills, and cognitive abilities;

vii. Results of an audiometric screening and/or audiologic evaluation, as appropriate;

viii. A summary of past speech-language treatment;

ix. Results of the trial period with the device; and

x. A list of recommended augmentative communication devices, including all necessary accessories, prices and provider information.

(b) Follow up visits will be made by the appropriate MDO staff, at their discretion, to monitor appropriate ACS use.

(c) Reimbursement can be made for ACS rental during the trial period in accordance with the policy contained at 10:59-1.7 regarding rental of DME.

N.J. Admin. Code § 10:59-1.13

Amended by R.2001 d.64, effective 2/20/2001.
See: 32 N.J.R. 4098(a), 33 N.J.R. 661(c).
In (a), substituted "beneficiary" for "recipient" throughout.