assistive techology devices

[marine_wife71099]

My son has autism, and they just gave him a device for school. I don't know yet if this device can come home, but our therapist said she thinks tricare pays for this device. Does anyone know if that is true? Also, what are the steps to getting that done????

[Christine]

Who gave it to him? If it's from the school, the school owns it and he can bring it home to use, but they retain ownership. They would also be paying for it.

If it's not from school then for tricare to cover it, you have to be on the EFM program and echo.

[marine_wife71099]

We are level 4 EFMP, and he we have ECHO. The school said that he needed it, so right now the school gave him one. I am questioning them on whether it will come home with him as well. I am just wondering if it doesn't, then how do I go about getting tricare to cover one for home like the one they are using at school???

[Christine]

Is it a speech device? If it is, it should cover it. I took this from an email from a yahoo group I belong to. If it's not a speech device, I highly recommend joining it and asking your question. The group owner knows a lot about dealing with tricare. I'm not sure on the procedure for submitting a claim for this. I would have an outside assistive technology eval done. If you use the school's, tricare may tell you the school has to get it for him, but then they'll retain ownership. The school should allow the device to go home with him.

http://health.groups.yahoo.com/group...autismsupport/

GOOD NEWS: The TRICARE policy on Augmentative Communication Devices (ACDs) and Speech Generation Devices (SGDs) is at Section 23.1 of Chapter 7 of the TRICARE POLICY MANUAL 6010.54-M, AUGUST 1, 2002 at http://manuals.tricare.osd.mil. The applicable CPT PROCEDURE CODES are 92605, 92607, 92608, 97755, and 97608. It states: A. ACDs (also referred to as speech generating devices (SGDs) and medically necessary services and supplies that provide an individual who has a severe speech impairment with the ability to meet functional speaking needs are covered. ACDs/SGDs are characterized by: 1. Being a dedicated speech device, used solely by the individual who has severe speech impairment; 2. May have digitized speech output, using pre-recorded messages, less than or equal to 8 minutes recording time; 3. May have digitized speech output, using pre-recorded messages, greater than 8 minutes recording time; 4. May have synthesized speech output, which requires message formulation by spelling and device access by physical contact with the device-direct selection techniques; 5. May have synthesized speech output, which permits multiple methods of message formulation and multiple methods of device access; or 6. May be software that allows a laptop computer, desktop computer or personal digital assistant (PDA) to function as a speech generating device. B. ACDs and SGDs as defined in 32 199.2 are considered voice prostheses. The prosthesis provisions found at Chapter 8, Section 4.1 apply. So, this policy should allow for an ACD or SGD for a non-verbal or limited-verbal individual with autism.

[marine_wife71099]

It is for speech because he is nonverbal. I was told by the school to wait to get one for him because you are only allowed one every 5 years, so they want to make sure this is the device for him before I get one. Thank you for the help!

[Christine]

You're welcome!