Skip to main content
  • This page, MassHealth Guidelines for Medical Necessity Determination for Augmentative and Alternative Communication Devices, Including Speech-Generating Devices, is   offered by
  • MassHealth

MassHealth Guidelines for Medical Necessity Determination for Augmentative and Alternative Communication Devices, Including Speech-Generating Devices

The MassHealth Guidelines for Medical Necessity Determination (Guidelines) are used by MassHealth's reviewing clinicians to determine the medical necessity of prior-authorization requests submitted by providers.

Skip table of contents

Table of Contents

You skipped the table of contents section.

MassHealth Guidelines for Medical Necessity Determination for Augmentative and Alternative Communication Devices, Including Speech-Generating Devices

These Guidelines for Medical Necessity Determination (“Guidelines”) identify the clinical information that MassHealth needs to determine medical necessity for coverage of augmentative and alternative communication (AAC) or speech generation devices. MassHealth bases these Guidelines on generally accepted standards of practice, review of the medical literature, and federal and state policies and laws applicable to Medicaid programs.

Providers should consult MassHealth regulations at 130 CMR 409.000, giving particular attention to Section 409.428. Providers serving members enrolled in a MassHealth-contracted managed care organization (MCO) or a MassHealth-contracted integrated care organization (ICO) should refer to the MCO’s or ICO’s medical policies for covered services.

MassHealth reviews requests for prior authorization (PA) on the basis of medical necessity. If MassHealth approves the request, payment is still subject to all general conditions of MassHealth, including member eligibility, other insurance, and program restrictions.

Additional Resources   for MassHealth Guidelines for Medical Necessity Determination for Augmentative and Alternative Communication Devices, Including Speech-Generating Devices

Open PDF file, 149.42 KB,  Guidelines for Medical Necessity Determination for Augmentative and Alternative Communication Devices, Including Speech-Generating Devices (English, PDF 149.42 KB)
Open DOCX file, 49.11 KB,  Guidelines for Medical Necessity Determination for Augmentative and Alternative Communication Devices, Including Speech-Generating Devices (English, DOCX 49.11 KB)

Help Us Improve Mass.gov  with your feedback

Please do not include personal or contact information.
Feedback