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Speech-language pathologist (SLP)

Qualification requirements

A qualified speech-language pathologist is an individual who has a master's or doctoral degree in speech-language pathology, and who meets either of the following requirements: 

  • Is licensed as a speech-language pathologist by the state in which the individual furnishes such services; or
  • In the case of an individual who furnishes services in a state which does not license speech-language pathologists:
    • Has successfully completed 350 clock hours of supervised clinical practicum (or is in the process of accumulating supervised clinical experience)
    • Performed not less than 9 months of supervised full-time speech-language pathology services after obtaining a master's or doctoral degree in speech-language pathology or a related field; and
    • Successfully completed a national examination in speech-language pathology approved by the Secretary

  • Provide services as a speech language pathologist in one of the following types of practices:
    • Solo practice
    • Partnership
    • Group practice
    • An employee of a solo practice, partnership, or group practice

CMS defers to each state’s licensure requirements for SLPs, to determine the most appropriate to provide speech-language pathology services to individuals/patients, including Medicare beneficiaries.

The state-licensed SLP may include provisional or temporary licensure as the individual completes required supervised experience/clinical fellowship and may enroll as an SLP in private practice (SLPPP) and/or work for providers furnishing outpatient Part B speech-language pathology services, consistent with state requirements.

Note: As a reminder, these Part B qualifications are not applicable to SLPs or the services they furnish that are billed/paid under Medicare Part A, which requires a full SLP license.

Documentation requirements and recommendations

Providers must submit an enrollment application by:

  • Completed CMS-855I form
  • Signed and dated certification statement:
    • The signature of the individual practitioner must be a handwritten signature (original signature not required)
    • Digital signatures (DocuSign or other software) are acceptable
    • A copy of the signature is acceptable; however, no stamped signatures can be accepted

or

  • Completed web application using PECOS:
  • Signed and dated certification statement of PECOS web application by:
    • E-signing electronically or
    • Uploading a signed and dated paper certification statement

and

  • Completed Electronic Funds Transfer (EFT) Authorization Agreement (CMS-588) or its equivalent in PECOS:
    • Must include associated documentation (e.g., copy of a voided check or account confirmation letter on bank letterhead)
  • If a provider already receives payments via EFT and is not making a change to banking information, the EFT is not required
  • Physicians and non-physician practitioners who are reassigning their benefits to another entity are not required to submit the CMS-588
  • Read CMS-588 Electronic funds transfer (EFT) for more information

Additional documentation requirements (when applicable)

Medicare may require additional documentation, when applicable, to validate key information submitted on the enrollment application or to address specific issues that could affect a practitioner’s potential eligibility for enrollment unfavorably (e.g., adverse legal actions).

Include copies of the following supporting documents, if applicable:

  • Copy of practitioner’s state medical license if not verifiable online
  • Copy of certification if not verifiable online
  • Certificate of completion, transcript, or diploma from accredited educational program(s) if requested
  • IRS document verifying provider’s TIN is associated with the provider’s legal business name (e.g., IRS CP 575)
    • Applies to clinics, groups, organizations, and institutional providers
  • Final adverse legal action documentation:
    • Include copies of legal documents associated with any final adverse action(s) taken against the provider
    • Include copies of any legal documents showing the resolution (e.g., notifications, reinstatement letters)
  • Completed Medicare Participating Physician or Supplier Agreement (CMS-460), if applicable:
    • A participating provider is one who bills Medicare directly and accepts assignment for covered services as payment in full
    • Physicians and non-physician practitioners who are reassigning their benefits to another entity are not required to submit the CMS-460

Good Standing Letter (GSL) - When there is no online source to verify a provider’s medical license in the U.S. Virgin Islands or Puerto Rico, the provider/supplier must supply a Good Standing Letter (GSL) or 120-Day Certification Letter from the State/Territory licensing authority:

  • A copy of the GSL or 120-Day Certification Letter issued by the State/Territory licensing authority must be submitted with each application received for initial enrollment, reactivations, revalidations, and change of information applications involving a license update/change
  • The GSL may have multiple names listed on the letter to show an active medical license
  • The GSL is valid if it was issued within:
    • 6 months of receiving the application for U.S. Virgin Islands
    • 12 months of receiving the application for Puerto Rico