How can communication services, including AAC devices, be documented as “medically necessary”?
For each case, the starting point is a review of the insurer’s definition of medical necessity. These definitions can vary considerably from one insurer to the next. Typically, medical necessity is tied to an identified condition or diagnosis that limits the person’s functioning in some way. In the case of communication, treatment would be medically necessary when the diagnosed condition (for example, cerebral palsy, brain injury, apraxia, ALS) impairs the individual’s ability to communicate effectively. Services/devices address the medical necessity by attempting to restore lost function, forestall further functional decline, or provide an alternative means of performing the function. It is actually difficult to imagine a situation in which communication services, including AAC supports, are not medically necessary, as most instances of significant communication limitations are associated with diagnosed conditions.
