Definitions

The following terms used in 130 CMR 413.000 have the meanings given in 130 CMR 413.402, unless the context clearly requires a different meaning. The reimbursability of services defined in 130 CMR 413.000 is not determined by these definitions, but by application of regulations elsewhere in 130 CMR 403.000 and in 130 CMR 450.000. Audiological Services – these services include, but are not limited to, testing related to the determination of hearing loss, evaluation of hearing aids, prescription of hearing aid devices, and aural rehabilitation. Audiologist – a person licensed by the Massachusetts Division of Registration in Speech Language Pathology and Audiology and certified by the American Speech-Language-Hearing Association (ASHA). Auditory Training – the training of the auditory modality to improve understanding of the speech or language of other speakers. Auditory training is one of the components of aural rehabilitation. Aural Rehabilitation – therapy, including, but not limited to, speech reading and auditory training, provided by a licensed certified audiologist or a licensed certified speech therapist either in a group or individually. Complete Audiological Evaluation – an evaluation that includes a routine audiological examination (air and bone conduction, spondee thresholds, and word-discrimination testing) and site-of-lesion testing (middle-ear testing or recruitment testing, or both, with analysis) as recommended by a physician. Comprehensive Evaluation – an in-depth assessment of a member’s medical condition, disability, and level of functioning to determine the need for treatment and, when treatment is indicated, to develop a treatment plan. Group Therapy – therapeutic services provided to more than one patient but less than seven patients in a single encounter, using group participation as a treatment technique. Hearing Aid Evaluation – a procedure conducted by an audiologist that may include: (1) an assessment of the member’s performance by appropriate tests (functional gain or real ear measurements, or both); (2) if a hearing aid is prescribed, a recheck of the member and hearing aid after the prescribed hearing aid has been fitted; and (3) if a hearing aid is prescribed, counseling related to the member’s adjustment to the use of the hearing aid. Maintenance Program – repetitive services, required to maintain or prevent the worsening of function, that do not require the judgment and skill of a licensed therapist for safety and effectiveness. Routine Audiological Evaluation – a procedure that includes: (1) a pure-tone audiogram, by air and bone conduction testing; and (2) speech threshold and discrimination testing. Speech and Language Pathology Services – the evaluation and treatment of communicative disorders with regard to the functions of articulation (including apraxia and dysarthria), language, voice, and fluency. Speech Reading – the training of the visual modality to improve the understanding of the speech or language of other speakers. Speech reading is one of the components of aural rehabilitation. Speech Therapist – a person currently licensed by the Massachusetts Division of Registration in Speech/Language Pathology and Audiology with a Certificate of Clinical Competence from the American Speech Language Hearing Association (ASHA). Speech/Language Therapy – therapy services, including diagnostic evaluation and therapeutic intervention, that are designed to improve, develop, correct, rehabilitate, or prevent the worsening of speech/language communication and swallowing disorders that have been lost, impaired, or reduced as a result of acute or chronic medical conditions, congenital anomalies, or injuries. Speech and language disorders are those that affect articulation of speech, sounds, fluency, voice, swallowing (regardless of presence of a communication disability), and those that impair comprehension, spoken, written, or other symbol systems used for communication.