EI: SLP Stipend and Guidance

Purpose: “EI: SLP Stipend” can be billed by subcontracted SLP providers billing Medicaid for one outpatient SLP encounter code for a speech and language session supporting IFSP outcomes.  Payment is $30 per date of service. Utilization and Activity will need to be created.

1. From the Utilization Details screen, select the Session Other button from the upper right corner

2. Enter Time (15-Minute Units) = 1

3. Rate (Hourly) =0

4. Enter Amount (If flat fee or credit)=$30

5. Click Save

Guidance

Background:

Early Intervention (EI) speech and language services provided for children enrolled in Medicaid and are billed as an outpatient encounter Speech Language Pathology (SLP) code are reimbursed at significantly less than unit based billing. This means that a 60 minute SLP session would be reimbursed at approximately $30 less than the average hourly rate for an SLP EI service provided to a child not enrolled in Medicaid. Medicaid’s reimbursement of a 60 minute SLP service is approximately $70 less than Medicaid reimbursement for a 60 minute Physical Therapy (PT) or Occupational Therapy (OT) service.

Encounter Code Billing:

Encounter code billing means that the encounter is paid at a set rate regardless of length of time spent in the session. Part of an expected EI service is the monitoring of progress towards Individualized Family Service Plan (IFSP) outcomes. OT/PT are able to bill for their units of time spent in session working on the families’ prioritized concerns and monitoring the IFSP (usually 4 units). SLPs can only bill 1 unit for their entire session working on families’ prioritized concerns and monitoring the IFSP regardless of time spent. Currently there is no way for SLPs to capture the additional time spent working on the monitoring of IFSP outcomes. Speech and language services are in high demand and there is a need to recruit and retain providers to provide this service, for both Medicaid-enrolled and non-Medicaid-enrolled children.

Important Information:

The Colorado Department of Early Childhood (CDEC) EI program received additional funding from the legislature to invest in the recruitment and retention of the EI Workforce. An EI Workforce Investment Committee was convened to make recommendations to the department on the best way to invest these funds. One of the decisions of the Committee was to recommend that the CDEC establish a $30 stipend for subcontracted providers that are billing Medicaid for a speech and/or language session for helping to support the monitoring of IFSP outcomes. This stipend is being implemented as of July 1, 2023. The stipend may be billed under the following circumstance:

1. A 60 minute session being billed for one outpatient SLP code which pays the Encounter Code rate set by Medicaid

This does not apply to:

1. A 30 minute SLP session billed for one outpatient SLP code which pays the Encounter Code rate

2. A 60 minute SLP session billed to a Revenue Code

3. A 30 minute SLP session billed to a Revenue Code

4. Any session provided by a direct service provider employed by a local early intervention program under contract with the CDEC

5. Sessions where two Encounter Codes are billed together

6. Sessions where an SLP Outpatient Evaluation Code is billed

7. Evaluations conducted by an Evaluation Entity and billed to the T1026 code