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Reno speech-language pathologist asks lawmakers for Medicaid pay parity and coverage of specialized CPT codes
Summary
A Reno speech-language pathologist and providers asked the subcommittee for pay parity between provider types and for Medicaid to reimburse three CPT codes that are not currently paid for provider type 34, arguing parity would aid recruitment and workforce stability.
Shauna Ross, a Reno-based speech-language pathologist and state association reimbursement advocate, told the Legislative Commissions Budget Subcommittee that Medicaid reimbursement rates for provider type 34 (therapy) lag those paid to provider type 60 (school-based services) by roughly 8'10 percent on average.
Ross said her training, education and licensure are identical regardless of practice setting and that a rate increase for provider type 34 would help recruitment and retention. "Our training, education and licensure are all the same regardless of practice setting," Ross said during public comment.
Ross also asked the department to add three specific Current Procedural Terminology (CPT) codes to the type-34 fee schedule because they are effectively unpaid for those providers: 92612 (flexible fiber optic endoscopic evaluation of swallowing), 92511 (nasopharyngoscopy with endoscope) and 31579 (diagnostic laryngoscopy with stroboscopy). She said these procedures are medically necessary and that local employers struggle to hire clinicians when payments are zero for those codes.
Other therapy providers called in to support a parity increase and broader rate adjustments that would reduce the workforce shortage in outpatient settings and improve access for Medicaid beneficiaries.
ADSD and Medicaid staff acknowledged workforce shortages in clinical areas and told the committee they were aware of provider recruitment concerns; the Medicaid presentation included workforce initiatives funded in part by pharmacy rebates and other budget actions.
Ending: Legislators asked Medicaid and DHS staff to provide rate- and cost-impact analyses for pay parity and to consider adding the three CPT codes to the fee schedule; staff agreed to return with fiscal estimates.
