Missouri manual section 6.31
Speech therapy
Official service name: Speech Therapy
Speech therapy can evaluate and treat speech, language, or hearing-related needs, including delayed speech, stuttering, motor-speech or aphasic disorders, and specialized communication or auditory training. It may also include consultation for families, caregivers, and other support providers.
What the manual describes
What this service can help with
- Evaluating speech, language, communication, or hearing-related needs
- Treatment for delayed speech, stuttering, spastic speech, or aphasic disorders
- Specialized auditory training, lip reading, signing, or hearing-aid use
- Consultation for families, caregivers, and habilitation-service providers
- Building or maintaining communication needed for community participation and independence
Source-backed working pathway
To establish you'll probably need:
These steps translate the cited manual section into a practical review sequence. Confirm the current local process before acting.
Describe the communication or hearing need and intended outcome.
Identify the speech, language, communication, auditory, signing, hearing-aid, or participation concern and connect it to an outcome in the person-centered service plan.
Confirm the age and state-plan pathway.
Verify that the person is age 21 or older. For someone under 21, access medically necessary speech and hearing-related treatment through the Healthy Children and Youth state-plan benefit rather than waiver speech therapy.
Obtain the physician prescription and required evaluation.
Secure the physician's prescription and a speech-language evaluation from a certified audiologist or state-certified speech therapist identifying the need and recommended treatment goals.
Identify a licensed and contracted speech-therapy provider.
Confirm Missouri licensure or qualifying provisional licensure, the required licensed supervision, and the provider's Department contract. Confirm that no paraprofessional will deliver the therapy.
Confirm authorization and the treatment plan.
Verify the authorized activities and units, the eight-unit daily maximum, caregiver-consultation needs, any virtual-delivery plan, documentation expectations, and the date for annual reevaluation.
Important boundaries
Limits that may affect fit or authorization
- The need must be identified in the person-centered service plan and prescribed by a physician.
- A speech-language evaluation must be completed by a certified audiologist or state-certified speech therapist.
- Waiver speech therapy is available only for people age 21 and older. Services for people under 21 must first be accessed through the Medicaid state-plan Healthy Children and Youth benefit.
- The waiver service must be additional to and cannot duplicate Medicaid state-plan speech therapy.
- The service cannot be provided by a paraprofessional.
- A provisionally licensed therapist must work under the required supervision of a licensed speech-language therapist.
- Virtual delivery must meet the additional requirements in Manual Section 7.
- The manual lists fifteen-minute units and a maximum of eight units per day.
- A written evaluation must be completed at least annually, and the evaluation and prescription must remain on file.
- Comprehensive and Community Support waivers remain under a temporary renewal extension through December 27, 2026, or until CMS grants final approval. Confirm the currently approved rules with the support coordinator; proposed renewal changes are not automatically active.
Do not assume this part
Questions to confirm locally
- Is the person age 21 or older?
- Has the Medicaid state-plan Healthy Children and Youth pathway been used or ruled out as applicable?
- Is the physician prescription current and on file?
- Who completed the required speech-language or audiology evaluation?
- Is the provider licensed, contracted, and providing any required provisional supervision?
- Will any service be virtual, and which Section 7 requirements apply?
- How many units are authorized, and when is the annual reevaluation due?