Speech Therapy Providers in Michigan

Medicaid speech therapy: EPSDT, MSA-115 and the PIHP route

Medicaid covers speech-language therapy for children under 21 when it is medically necessary, under the federal EPSDT benefit. In fee-for-service Medicaid, the therapist sends a prior authorization request to MDHHS through CHAMPS or on form MSA-115, with the initial evaluation and treatment plan attached. Speech therapy that was not approved in the request is not covered. If your child is in a Medicaid Health Plan, call the plan, because it sets its own authorization steps. A child with an autism diagnosis who qualifies for behavioral health treatment through the PIHP can have related speech therapy covered there.

• Ask the speech therapist to confirm the authorization route before the first visit.
• Request more visits before the current approval period ends; MDHHS asks for extension requests within 15 days of the end date.

Michigan's 30-visit benchmark and the autism insurance law

Michigan's essential health benefit benchmark covers habilitative speech therapy with a yearly limit of 30 visits. The state insurance department says plans must offer at least 30 speech visits, kept separate from the 30 combined physical and occupational therapy visits. Section 3406s of the Insurance Code adds a second path: for a child diagnosed with an autism spectrum disorder, insurers cover therapeutic care from a licensed or certified speech therapist, and may not limit the number of visits. Self-funded employer plans follow federal ERISA rules, not these state laws.

Children's Waiver Program and Medicaid regardless of parent income

The Children's Waiver Program lets Medicaid fund home and community-based services for children under 18 with a documented developmental disability and a need for support at home. Parent income is not counted when Medicaid eligibility is decided. You start by calling the Access Center for your county's Community Mental Health agency, and MDHHS sends an invitation to apply when an opening occurs. The program serves 669 children a year and fills openings monthly. A child who gains Medicaid this way can then use EPSDT speech therapy.

Early On Michigan for children from birth to age three

Early On Michigan serves children from birth to age three who have a 20% diagnosed delay. The state lists delays in speech and language as an eligible delay, and says there is no cost for qualified children and their families. MiLEAP runs the program as Michigan's Part C lead agency. Call 1-800-EarlyOn (800-327-5966) or complete the online referral form. A late talker does not need a clinic referral first, so you can start the call before a private evaluation is scheduled.

Speech and language impairment under Michigan's special education rules

At age 3, the local school district becomes responsible for a free appropriate public education. Michigan's eligibility category is speech and language impairment (R 340.1710): a language, articulation, fluency or voice impairment that affects educational performance. A language impairment needs a spontaneous language sample and results from two standardized tests or subtests. Request an evaluation in writing. The district has 10 school days to send notice and ask for consent, then 30 school days from your signed consent to offer services or find your child ineligible.

• A child whose main disability is something else can still receive speech and language services (R 340.1745).
• Speech-language pathologists working for schools must be licensed, certificated or registered (R 340.1792).

Michigan Board of Speech-Language Pathology and the compact

Speech-language pathologists in Michigan are licensed by the Michigan Board of Speech-Language Pathology under Part 176 of the Public Health Code. The titles speech-language pathologist, speech pathologist and speech therapist are protected for licensed people. Ask any therapist for a Michigan license number and check it before you start. ASHA's CCC is a national certification and does not replace the state license. The ASLP Interstate Compact lists Michigan as active legislation, not enacted, so out-of-state therapists cannot yet practice in Michigan through a compact privilege.