AAC Device Funding for Children and Adults

This guide is for parents of children who need AAC (augmentative and alternative communication), adults who need it, and the family helping them. Begin with a speech-language pathologist’s evaluation and device trial, then match the request to the payer: Medicare, Medicaid (EPSDT for children under 21), a private plan, the school, vocational rehabilitation or the VA.

Key takeaways

A speech-language pathologist leads the AAC evaluation and brings in occupational and physical therapists for positioning and access; AAC has no prerequisites.⁠¹
Medicare covers a speech-generating device as durable medical equipment when seven criteria are met, starting with a written evaluation before delivery by an SLP with no tie to the supplier.⁠^2,3
Medicare does not pay for a general tablet or computer, or for features unrelated to communication; on a general tablet it can pay for the speech software alone.⁠^2,4
For a child under 21 in Medicaid, EPSDT covers medically necessary, Medicaid-coverable services even when the state plan omits them; at any age, a state may not exclude medical equipment outright.⁠^5,6
Individual and small-group plans, including Marketplace plans, must cover rehabilitative and habilitative services and devices.⁠^7,8
A school must provide an assistive technology device when a child’s IEP requires it, at no cost to parents, and at home when the IEP team decides the child needs it there.⁠^9,10
State assistive technology programs lend devices to try before buying, and vocational rehabilitation and the VA can provide communication technology to people who qualify.⁠^11,12,13

What is AAC, and do you need a device to use it?

AAC is any way of communicating that adds to speech or takes its place, and many forms need no device at all. ASHA describes tools and techniques that help a person express thoughts, needs, feelings and ideas, used alongside speech, in place of speech that is absent or not functional, or for a short time, such as after surgery.⁠^1,14 The options fund differently:

No-tech and low-tech: gestures, signs, picture and letter boards, and writing. An SLP typically makes these, and they do not usually need separate funding.⁠¹
Apps on a tablet or smartphone: ASHA counts these among high-tech options and notes that payers’ coverage of tablets, apps and computers varies.⁠^1,14
Speech-generating devices (SGDs): equipment that produces recorded or synthesized speech, which Medicare classes as durable medical equipment, the category health plans most often fund.⁠^2,15

ASHA states there are no prerequisites for AAC intervention, and the consumer page that ASHA’s public AAC address now opens adds that children younger than 3 can start, with no test score or milestone required.⁠^1,14 AAC does not replace speech: people use both, and ASHA notes AAC may help improve natural speech when used alongside other ways of communicating.⁠^1,14

Who evaluates a child or adult for an AAC device?

A speech-language pathologist (SLP) leads the evaluation for children and adults alike; ASHA gives SLPs the central role in assessing and treating people who need AAC, including writing the reports funders ask for.⁠¹ Others join when the question goes beyond language:

Occupational and physical therapists advise on positioning and motor access, such as whether a hand, the head or the eyes can make selections reliably, and on accessories such as mounts.⁠^1,14
A vision specialist, rehabilitation engineer or assistive technology professional may be brought in by the SLP.⁠¹
The treating doctor or other practitioner writes the order a health plan needs; for Medicare, the SLP’s evaluation reaches that practitioner before the device is ordered.⁠³
For a school-age child, the school SLP considers the need for AAC and runs trials within the individualized education program (IEP), the written plan for the child’s special education.⁠^1,16

An occupational or physical therapist’s report on seating or access supports the request; it does not stand in for the SLP’s evaluation, which Medicare requires.⁠³

What happens during an AAC evaluation and device trial?

The evaluation works out what the person needs to say, to whom, and how they can reach a system, and it usually continues into device trials. ASHA’s typical components include a case history with the prognosis where a condition may progress, the person’s own goals and preferences, vision, and physical access.⁠¹ Families take part too, because lack of family involvement is a significant factor when people abandon a device.⁠¹

Trials matter because success with a specific device often cannot be judged at the first assessment, and a payer may require the SLP to consider several devices that are not from the same manufacturer or product line.⁠¹ Vendors may help with paperwork, but ASHA says that does not replace a comprehensive evaluation, and an SLP writing a funding request must disclose any financial relationship with a manufacturer.⁠¹ For Medicare, the evaluating SLP may not work for the supplier or have a financial relationship with it.⁠³

Which program pays for an AAC device in your situation?

The payer depends on age, coverage and goals: the National Joint Committee for the Communication Needs of Persons With Severe Disabilities, whose page ASHA hosts, names age, disability, income and interest in employment.⁠¹⁵ Children also have school services from age 3 through 21 and early intervention before 3, while adults have no entitlement to free assistive technology and rely on the other routes below, including the VA for veterans.⁠^13,15,17,18

Payer	Who evaluates	What it requires	What it covers	Where to appeal
Original Medicare	An SLP with no tie to the supplier⁠³	A written SLP evaluation before delivery, then the practitioner’s order⁠³	The device and needed accessories, for use at home⁠^2,19	Redetermination, by the date on the Medicare Summary Notice⁠²⁰
Medicare Advantage	The same, under Medicare’s rules⁠²¹	Medicare’s criteria, plus any prior authorization⁠²²	Everything Original Medicare covers⁠²²	The plan, within 65 days of the notice’s date⁠²³
Medicaid, under 21	An SLP, on a practitioner’s referral⁠²⁴	Medical necessity, case by case under EPSDT⁠⁵	Coverable services even if the state plan omits them⁠⁵	A state fair hearing⁠⁶
Medicaid, adult	An SLP, where the state covers speech services⁠²⁵	A practitioner’s order and yearly review⁠⁶	Medical equipment, not limited to Medicare’s list⁠⁶	A state fair hearing⁠⁶
Job-based or Marketplace plan	An SLP; ask whether one in network is required	Preauthorization and the plan’s medical necessity terms⁠²⁶	Habilitative and rehabilitative devices, in individual and small-group plans⁠^7,8	Internal appeal within 180 days⁠²⁷
School, ages 3 to 21	The IEP team, after an evaluation in the child’s usual setting⁠^16,28	A need for it to receive a free appropriate public education⁠⁹	The device and services, at no cost to parents⁠^9,10	Due process complaint, within 2 years or the state’s limit⁠²⁹
Early intervention, under 3	The team writing the family’s service plan⁠¹⁸	A developmental need, such as communication⁠¹⁸	Assistive technology devices and services⁠¹⁸	Ask the service coordinator for the program’s written dispute steps
Vocational rehabilitation	A VR counselor, with rehabilitation technology staff⁠^12,30	An impairment that substantially impedes employment⁠³⁰	Rehabilitation technology⁠¹²	An impartial due process hearing⁠³¹
VA	A VA speech-language pathologist⁠³²	VA enrollment and care⁠³³	Communication devices that are part of treatment⁠¹³	The patient advocate at your VA medical center⁠³⁴

Medicaid and the school decide separately for the same child: Medicaid may cover a device that is medically necessary even when it is also educationally necessary, and the school may not delay what the IEP requires while it waits for another funder.⁠¹⁵

What does Medicare require to cover a speech-generating device?

Medicare Part B covers a speech-generating device as durable medical equipment for a severe speech impairment when all seven criteria in its equipment contractors’ coverage policy are met.⁠^2,3 In plain terms:

A formal, written SLP evaluation of cognitive and communication abilities, done before delivery.⁠³
A medical condition causing a severe expressive speech impairment.⁠³
Speaking needs that natural ways of communicating cannot meet.⁠³
Other forms of treatment considered and ruled out.⁠³
A device expected to benefit the speech impairment.⁠³
The SLP’s evaluation and recommendation sent to the treating practitioner before ordering.⁠³
An evaluating SLP with no employment or financial tie to the supplier.⁠³

If any criterion is missing, the device is denied as not reasonable and necessary, and claims for a second device are denied too.⁠³ The letter outline below includes everything the evaluation must cover, and the supplier needs a standard written order from the practitioner before billing.⁠³ The device is an equipment claim, separate from speech therapy visits, which the Medicare therapy coverage guide covers.⁠²

Which device features and tablets does Medicare not pay for?

Medicare pays for communication, not general computing. Computers and tablets are generally not durable medical equipment because they are useful to people without an illness or injury, and features such as documents, games, music or video calls are not covered, so their cost is yours; email, text and phone messages are covered.⁠²

A tablet-based device qualifies only if its maker designs it to work solely as a speech-generating device when first issued; on an ordinary tablet, Medicare can pay for the speech software only.⁠⁴ Internet and phone service and carrying cases are not covered, and neither are upgrades within the device’s 5-year useful lifetime.⁠^2,4

Suppliers are encouraged to give you a voluntary Advance Beneficiary Notice of Noncoverage (ABN) naming the features Medicare does not cover; an ABN moves the cost of an item Medicare is expected to deny onto you, so read it before signing.⁠^2,35 Part B covers equipment ordered for use in your home, and ASHA notes Medicare may not cover AAC devices in settings such as a skilled nursing facility or hospice.⁠^1,19

Does Medicare cover eye-gaze access and mounting systems?

Yes, when the person meets the same seven criteria and the SLP’s evaluation documents the need for each accessory:⁠^3,4

Eye tracking and gaze interaction, which let a person communicate with their eyes, covered with a demonstrated medical need.⁠^3,4
Alternative input, such as joysticks or specialty keyboards, covered when standard input cannot be used and the evaluation explains why.⁠^3,4
Mounts and stands that put the device or switches within reach, and electronics that let a power wheelchair’s drive control run the device.⁠⁴

Software, batteries and chargers that come with the device are part of its payment.⁠⁴ If Medicare denies the device, it denies the accessories too, so put the access method in the first request, with an occupational or physical therapist’s input as ASHA suggests.⁠^1,3

What do you pay for a speech-generating device under Medicare?

In 2026 you pay the $283 Part B deductible once for the year, then 20 percent of the Medicare-approved amount, if your supplier accepts assignment.⁠^19,36 A participating supplier must accept assignment; one that does not participate may charge more, and Medicare pays only suppliers enrolled in Medicare.⁠¹⁹

Some equipment is rented and some bought.⁠¹⁹ Speech-generating devices and the accessories needed to use them have been in CMS’s routinely purchased category since October 1, 2015, paid as a rental or a lump-sum purchase with total payments capped at the purchase amount.⁠³⁷ Ask the supplier in writing which it plans, the approved amount and your share.

How does Medicare Advantage handle speech-generating devices?

A Medicare Advantage plan must cover everything Original Medicare covers and follow CMS’s national coverage determinations and the local contractors’ written coverage decisions, so the same criteria apply.⁠^21,22 It may require prior authorization, so ask before the evaluation what it needs and which suppliers it uses.⁠²²

How does Medicaid pay for an AAC device for a child under 21?

For a child under 21 enrolled in Medicaid, EPSDT (the Early and Periodic Screening, Diagnostic and Treatment benefit) requires the state to cover any Medicaid-coverable service found medically necessary to treat, correct or reduce the child’s condition, whether or not the state plan lists it, decided case by case.⁠⁵ Equipment is coverable: Medicaid’s home health benefit includes medical equipment for use wherever normal life takes place, and it is not limited to what Medicare treats as durable medical equipment.⁠⁶

The therapy has its own wording: speech services need a referral from a physician or other licensed practitioner, while physical and occupational therapy are prescribed.⁠²⁴ Send the SLP’s evaluation, the order, and a letter explaining how the device corrects or ameliorates the condition, in EPSDT’s terms.⁠⁵ If the device is also needed at school, say so, since Medicaid may cover a medically necessary device that is educationally necessary as well.⁠¹⁵ A state denying an equipment request must tell you of your right to a fair hearing; the therapy appeal guide covers managed care appeals and hearings.⁠⁶

What does Medicaid cover for an adult who needs an AAC device?

An adult has no EPSDT, so the state plan decides. Medicaid.gov lists home health services, which include medical equipment, among the benefits every state must provide, and speech, hearing and language services among optional ones, so a state can cover the device even where it limits an adult’s speech therapy.⁠^6,25 The federal rule also helps:

A state may keep a preapproved equipment list but may not exclude an item outright, and must offer a process, with reasonable and specific criteria, to request items not on it.⁠⁶
Home health services cannot be limited to people who are homebound.⁠⁶
A physician or other licensed practitioner orders the equipment and reviews the need for it every year.⁠⁶

Ask about home and community-based waivers too, which the joint committee lists among adult funding options.⁠¹⁵

Does a private or job-based health plan pay for AAC devices?

It depends on the plan document, but individual and small-group plans, including Marketplace plans, must include rehabilitative and habilitative services and devices among their essential health benefits.⁠^7,8 Habilitative care helps a person keep, learn or improve skills for daily living, and these plans may not limit it less favorably than rehabilitative care.⁠³⁸ What each category includes varies with your state’s requirements, and a large employer’s plan follows its own document, since the rule covers the individual and small-group markets.⁠^7,8

Expect preauthorization, the plan’s decision that equipment is medically necessary, which is not a promise to pay.⁠²⁶ Medical necessity generally means care needed to diagnose or treat a condition that meets accepted standards of medicine, but insurers word it differently, so get your plan’s exact definition and answer it point by point.⁠^15,39 Partner training and device programming may not be covered, so ask before delivery.⁠¹⁵ If the plan says no, file an internal appeal within 180 days; if it has no in-network SLP who evaluates for AAC, see the guide for when no in-network therapist is available.⁠²⁷

What should an AAC letter of medical necessity include?

A detailed, publicly available checklist is the one Medicare’s equipment contractors use, a sound outline for any payer once you add that payer’s criteria.⁠³ The joint committee frames medical necessity for communication devices as restoring lost function, slowing decline, or giving another way to perform the function.⁠¹⁵

Letter of medical necessity for an AAC device: an outline for the SLP

The impairment: diagnosis, type and severity, language and cognitive skills, and the expected course, including whether it is progressive.
Natural communication: why speech, writing or gestures cannot meet daily needs, with examples from home, school, work or medical visits.
Goals: the functional communication goals, and the treatment options considered and ruled out.
The trial: the devices tried, from which makers, and what the person did with each.
The recommendation: the device, software and each accessory with its reason, including why standard input cannot be used if alternative access is requested.
Ability and training: the abilities shown in the trial, and a training schedule for the person and their partners.
An upgrade, if requested: what the new device adds over the one the person has.
The payer’s criteria: each one quoted and answered.
Independence: a statement that the SLP has no financial relationship with the supplier or manufacturer.

[the SLP’s name, credentials and signature] · [the date]

Does your child’s school have to provide an AAC device?

Yes, when the IEP team decides the child needs one: under IDEA, the school must make assistive technology devices and services available when the child’s special education, related services or supplementary aids require them.⁠⁹ Every IEP team must consider whether the child needs assistive technology, which covers anything from picture cards to a speech-generating device.⁠^15,16,40

The duty covers more than the device: evaluating the child in their customary environment, maintaining and repairing the device, and training the child and, where appropriate, the family.⁠²⁸ A school device goes home when the IEP team decides the child needs it there to receive a free appropriate public education, so ask the team to decide and record it.⁠⁹

The school may bill Medicaid with your consent but may not require you to enroll or pay a deductible or copay; it may use private insurance only with your consent each time, and refusing does not end its duty to provide services at no cost to you.⁠¹⁰ It may not hold back technology the IEP requires while waiting for another funder, and may need its own inventory, a loan program or a short-term rental meanwhile.⁠¹⁵

A child with a Section 504 plan is owed education with related aids and services, free of charge, so ask whether AAC belongs among them.⁠⁴¹ If you and the school disagree, a parent may file a due process complaint, generally within two years or the time state law allows.⁠²⁹ For school therapy alongside private therapy, see insurance and therapy for children.

Who owns an AAC device that the school paid for?

The school does: the joint committee says a device the school purchases belongs to the school, while one paid for by private health insurance belongs to the person it was bought for.⁠¹⁵ A school cannot compel a family to use its private insurance, though some families choose to co-fund.⁠¹⁵

Ask in writing whether a school device goes home, who updates its vocabulary, who repairs it, and what happens over breaks, after a move and when your child leaves school. ASHA lists transition support and documentation for a student leaving school with AAC among the school SLP’s roles, so ask for both early.⁠¹

Can early intervention provide an AAC device before age 3?

Yes. IDEA Part C early intervention includes assistive technology devices and services for infants and toddlers, with communication among the areas it addresses, at no cost unless federal or state law sets family payments such as a sliding fee scale.⁠¹⁸ The state may not use your private insurance without consent or make enrolling in Medicaid a condition of services.⁠⁴² Plan the handoff at age 3, when the school’s duty begins.⁠¹⁷

What other programs help pay for or lend AAC devices?

State assistive technology programs serve people of all ages, vocational rehabilitation serves people working toward a job, and the VA serves enrolled veterans.⁠^11,13,43

How can your state’s assistive technology program help?

Every state, the District of Columbia, Puerto Rico and the territories has a federally funded assistive technology program, and each runs four activities:

Demonstrations, to compare devices hands on with a knowledgeable professional.⁠¹¹
Device loans, to borrow a device for a limited time and see whether it meets the person’s needs before a purchase.⁠¹¹
Reuse, passing a device its first owner no longer needs to a new owner at substantial savings.⁠¹¹
Financing, such as loans to acquire a device.⁠¹¹

A loan is a practical home trial, and ASHA points school teams to these programs for loaner and trial equipment; keep the funding request moving while you borrow.⁠^1,11

Can vocational rehabilitation fund an AAC device for work?

Yes, for a person whose impairment is a substantial impediment to employment and who needs services to prepare for, get, keep or advance in a job.⁠³⁰ VR services include rehabilitation technology: assistive technology devices and services and telecommunications, sensory and other technological aids.⁠^12,44 An agency generally checks for comparable benefits from other programs first, but rehabilitation technology is exempt from that check.⁠⁴⁵ VR aims at competitive integrated or supported employment and may provide pre-employment transition services to students with disabilities; a refusal can go to an impartial due process hearing.⁠^31,43

Does the VA provide AAC devices to eligible veterans?

Yes. VA rules list communication devices among items VA provides to enrolled veterans receiving VA care, when the item is a direct and active part of treatment and rehabilitation, not only for comfort or convenience.⁠^13,33 A communication device is anything that compensates for a communication deficiency, from a symbol board to an electrolarynx.⁠⁴⁶ VA speech-language pathologists recommend the technology, including tablet apps and speech devices run by an eye gaze switch, for veterans with conditions such as ALS, Parkinson’s disease and multiple sclerosis.⁠³²

What should you know before paying for AAC yourself?

Ask your plan before you buy, because a purchase outside its process may not be paid back: plans decide equipment through preauthorization, and Medicare pays only enrolled suppliers.⁠^19,26 An app on a family tablet can be a quick start, but check first, since payers’ coverage of tablets and apps varies.⁠¹

If you have no coverage for the evaluation, or choose not to bill a job-based or individual plan, the clinic owes you a written good faith estimate within 3 business days of asking, and any question about cost counts as asking.⁠⁴⁷ The guides to adult therapy without insurance and children’s therapy without insurance cover paying for visits. Before applying to a charity, confirm its current eligibility, deadline and any required supplier on its own site.

What questions get you a real cost from the supplier and the plan?

Ask for a written quote from the supplier and a written benefit answer from the plan, item by item, because approval of the device does not settle every cost.⁠^3,15

Part of the cost	What to ask in writing
Evaluation	Is it billed to my plan, and is the written report included?
Trial or loan	How long, and is there a deposit or shipping charge?
Device and software	Which model, what approved amount, and what share is mine?
Access and mount	Are eye tracking, switches and the mount requested and priced separately?
Training	Who trains the user and family, and how is it billed?
Repairs	What does the warranty cover, and is there a loaner during repairs?

Questions for the equipment supplier and the plan

To the supplier:

"Are you enrolled with [Medicare / my Medicaid plan / my health plan], and do you accept its payment as full payment?"
"Please send a written quote listing the device, software, each accessory and the mount, with the approved amount and my share for each."
"Is this a purchase or a rental, and is there any feature you plan to charge me for that the plan does not cover?"

To the plan:

"Which benefit covers a speech-generating device for [the person’s name], member ID [the ID], and is there a limit?"
"Must the evaluating SLP and the supplier be in network, and what must the report and order include for preauthorization?"
"Are accessories, training, programming and repairs covered? Please send the coverage policy you apply."

What should you ask the speech-language pathologist first?

Ask about AAC experience before booking, since ASHA expects an SLP without enough AAC training to refer to, or at least consult, one who has it.⁠¹

Questions for a speech therapy clinic before an AAC evaluation

"I am looking for an AAC evaluation for [my child / myself / my family member], age [the age].

Does an SLP here evaluate for speech-generating devices for [children / adults], and which devices can you trial?
Do you work with an occupational or physical therapist on positioning and access, such as eye gaze or switches?
Can the trial happen at home or school, or through a state assistive technology loan?
Do you write the evaluation and letter for [Medicare / Medicaid / my plan], and who submits the request?
Do you have any financial relationship with a device maker or supplier?
Who trains us after delivery, and what happens if the request is denied?"

To find a clinic, search speech therapy clinics on DrSensory by location. DrSensory is a free directory families use to find occupational, physical and speech therapy clinics for children and adults; each listing is a clinic rather than an individual therapist, and DrSensory does not check clinical quality, rank clinics by payment, or sell or fund AAC devices. A message you send a clinic through DrSensory is read by that clinic in its portal. For autistic children, see speech therapy for autism.

What should you do if an AAC device request is denied?

Get the reason in writing, ask for the criteria the payer used, have the SLP answer each point, and appeal by the deadline in the table above.⁠^20,27 Under Medicare, check the denial against the seven criteria: a gap such as the practitioner not receiving the SLP’s report before ordering is something the team can correct.⁠³ In Medicaid, an item missing from the state’s list can still be requested through its exception process.⁠⁶ The therapy appeal guide has the letter, call script and deadlines in full.

How can you keep communicating while funding is pending?

Ask the SLP for interim supports now; low-tech boards and books are typically made by the SLP and do not usually need separate funding.⁠¹ A state assistive technology loan can bridge the wait, and for a school-age child the school may need to arrange temporary access, such as its own equipment or a short-term rental.⁠^11,15

For a progressive condition such as ALS, timing matters. ASHA advises voice banking, recording the person’s voice to build a synthetic one, while speech is still clear, and Medicare’s evaluation records the expected course so the access method can change with it.⁠^1,3 ASHA’s assessment starts from the person’s own goals and preferences, so include words for the person’s own goals and preferences, not only requests.⁠¹

What happens after the AAC device arrives at home?

Training comes first. ASHA describes AAC intervention as starting with teaching the person and family to use the device, and communication partners learn skills such as waiting longer for the person’s turn.⁠¹ The joint committee notes Medicare may cover programming and training, so ask the clinic how follow-up visits are billed.⁠¹⁵

At delivery, check that the device, software and accessories match what was approved and that the access method works from the person’s real chair or bed. Ask who owns the device and software account, how backups work, and who can see stored messages. Keep one tracker:

Step	Who is responsible	Date and status	Next action
Evaluation and trial
Funding route and policy
Report, order and submission
Decision or appeal
Delivery, setup and training
Repairs and follow-up

What does AAC funding look like for a child and an adult?

Hypothetical: a 6-year-old with Medicaid and an IEP

Leo, 6, has cerebral palsy, Medicaid and an IEP, and answers yes and no with his eyes.

Month 1. His SLP evaluates him; an occupational therapist finds his head control unreliable for selections, so the trial adds eye gaze.
Month 2. A state assistive technology loan confirms eye gaze works at home.
Month 3. The SLP’s report and his doctor’s order go to Medicaid, explaining under EPSDT how the device ameliorates his condition.
Month 4. Medicaid approves the device but denies the mount as unlisted; his mother asks for review through the state’s process for unlisted items.

The months are inputs for this example, not typical timelines.

Hypothetical: a 68-year-old with ALS and Original Medicare

Ruth, 68, has ALS; her speech is slowing but still clear.

Week 1. She starts voice banking and gets a referral to an SLP who evaluates for AAC.
Week 3. The SLP, with no tie to any supplier, records the expected course of ALS, trials devices from two makers, and recommends one with a head mouse.
Week 4. Her neurologist sends a standard written order to an enrolled supplier that accepts assignment.
Delivery. She owes any unmet Part B deductible and 20 percent of the approved amount, and signs a voluntary ABN for a music feature Medicare does not cover.
Month 8. As her head control weakens, the SLP documents her need for eye tracking as an accessory.

The weeks and device choices are inputs for this example, not typical results.

Frequently asked questions

Does insurance pay for an iPad used as an AAC device?

Medicare does not pay for the tablet itself, which it treats as a general computing device, though it can pay for speech software installed on one.⁠^2,4 ASHA notes that other payers’ coverage of tablets and apps varies, so ask the plan in writing before buying.⁠¹

Does someone have to stop talking before they can use AAC?

No. AAC can add to speech as well as replace it, people who use AAC can use both, and ASHA notes that AAC may help natural speech when used alongside other ways of communicating.⁠^1,14

Is there a minimum age for an AAC device?

No. Children younger than 3 can start using AAC, with no test score or milestone required, and early intervention can provide assistive technology to infants and toddlers.⁠^14,18

Can a child take a school AAC device home?

Yes, when the IEP team decides the child needs it at home or elsewhere to receive a free appropriate public education; that decision is made case by case, so ask for it in the IEP.⁠⁹

Does Medicare pay for AAC training and programming?

Medicare’s evaluation must include a training schedule for the device, and the joint committee notes that Medicare may cover programming and training.⁠^3,15 Ask the clinic how it bills those visits before delivery.

How often does Medicare replace or upgrade a speech-generating device?

Medicare treats 5 years as the device’s useful lifetime and does not cover upgrades to the device or its software within it; replacement software is covered only after 5 years of use, a change in the person’s condition, or loss, theft or irreparable damage.⁠⁴

Can the SLP who evaluates work for the device company?

Not for Medicare: the evaluating SLP may not be the supplier’s employee or have a financial relationship with it.⁠³ For any payer, ASHA requires an SLP writing a funding request to disclose financial ties to device manufacturers.⁠¹

Who owns an AAC device that private insurance paid for?

The person it was bought for, according to the joint committee, while a device the school purchases belongs to the school.⁠¹⁵

Are parents and family trained on the AAC device too?

They should be. A school’s assistive technology services include training the family where appropriate, and ASHA’s AAC treatment starts with training the person and family.⁠^1,28 Ask a health plan whether partner training is covered, since the joint committee warns it may not be.⁠¹⁵

Does DrSensory sell or pay for AAC devices?

No. DrSensory is a free directory for finding occupational, physical and speech therapy clinics for children and adults; it does not sell, fund or supply devices. Use it to find a speech therapy clinic for the evaluation, then ask the clinic about its AAC experience.

Sources

American Speech-Language-Hearing Association. Augmentative and Alternative Communication (ASHA Practice Portal, professional issues). Checked October 24, 2026.
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“Augmentative and alternative communication (AAC) is an area of clinical practice that supplements or compensates for impairments in speech-language production and/or comprehension, including spoken and written modes of communication.”; “AAC uses a variety of techniques and tools to help the individual express thoughts, wants and needs, feelings, and ideas”; “AAC is augmentative when used to supplement existing speech, alternative when used in place of speech that is absent or not functional, or temporary as when used by patients postoperatively in intensive care”; “High-tech options include the following: computer/tablet/smartphone communication apps”; “Speech-language pathologists (SLPs) play a central role in the screening, assessment, diagnosis, and treatment of persons requiring AAC intervention.”; “Refer to other professionals (rehabilitation engineer, AT professional, occupational therapist, physical therapist, music therapist, vision specialist, special educator, respite care worker)”; “Generate reports to help with funding and collaborate with funding agencies.”; “Provide trial periods with AAC systems and collect data.”; “Consider the student’s need for AT, including AAC.”; “Provide transition support and documentation if AAC is deemed necessary for the student as they exit the school system.”; “There are no prerequisites for AAC intervention”; “All individuals are considered candidates for AAC intervention if their communication abilities do not meet communication needs.”; “AAC use may help improve natural speech when used in a multimodal approach”; “physical/motor status —means of access to the AAC system (positioning, fine motor, gross motor)”; “prognosis and potential for disease progression, when applicable”; “individual’s goals and preferences”; “Trials of specific devices are often a component of AAC treatment, and an individual’s success with a specific device may not be effectively determined upon initial assessment.”; “Lack of family involvement in the AAC process is cited as a significant factor in device abandonment.”; “Once an AAC system is selected, intervention will initially focus on training the individual and their family/caregivers in how to use the device and/or system components”; “increasing wait time for conversational turn-taking”; “Voice banking should be completed when a communicator’s energy and skills are sufficient to generate clear speech.”; “an individual can record a large inventory of speech, which is then used to create a synthetic voice that approximates their natural voice”; “If an SLP has inadequate experience/training and is unable to assist an AAC user, an SLP refers to or (at minimum) consults with an SLP with experience in AAC.”; “Low-tech or light-tech AAC systems are typically created by an SLP and do not typically require or qualify for additional amounts of funding.”; “A payer may require that an SLP consider multiple SGDs during their evaluation process and that those devices must not be from the same manufacturer or product line.”; “SGD vendors may be able to assist with funding questions and may have templates for meeting payer standards; however, this does not take the place of a comprehensive AAC evaluation.”; “SLPs writing AAC evaluations and completing funding requests must disclose any financial relationships that they have with device manufacturers”; “Medicare may not cover AAC devices in all settings (e.g., skilled nursing facilities, hospice).”; “Tablets, apps, and computers are considered nondurable, nondedicated devices, and payers’ coverage for these devices varies.”; “A team-based approach is suggested when considering appropriate accessories, particularly with considerations from physical therapy and occupational therapy.”; “the need for interdisciplinary collaboration with physical and/or occupational therapy to establish optimal positioning for access”; “partnering with a state tech-act agency or a regional or state support center to obtain materials and equipment for loaner and trial periods”.
Centers for Medicare & Medicaid Services. Medicare National Coverage Determinations Manual, Chapter 1, Part 1 (§50.1, Speech Generating Devices, Rev. 184, effective July 29, 2015; last reviewed July 2015). Checked October 24, 2026.
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“Speech generating devices are considered to fall within the durable medical equipment (DME) benefit category”; “They are covered for patients who suffer from a severe speech impairment and have a medical condition that warrants the use of a device”; “Other covered features of the device include the capability to generate email, text, or phone messages”; “Computers and tablets are generally not considered DME because they are useful in the absence of an illness or injury.”; “Internet or phone services or any modification to a patient’s home to allow use of the speech generating device are not covered by Medicare”; “such as hardware or software used to create documents and spreadsheets or play games or music”; “including video communications or conferencing”; “the cost of these features are the responsibility of the beneficiary”; “Suppliers of speech generating devices are encouraged to furnish the beneficiary with a voluntary Advance Beneficiary Notice (ABN), or similar notice, which informs that these features are not covered”.
CGS Administrators and Noridian Healthcare Solutions, the Medicare durable medical equipment contractors, in CMS’s Medicare Coverage Database. Local Coverage Determination L33739, Speech Generating Devices (SGD) (version 23, revision effective October 1, 2024). Checked October 24, 2026.
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“Prior to the delivery of the SGD, the beneficiary has had a formal evaluation of their cognitive and communication abilities by a speech-language pathologist (SLP).”; “Current communication impairment, including the type, severity, language skills, cognitive ability, and anticipated course of the impairment;”; “An assessment of whether the individual’s daily communication needs could be met using other natural modes of communication;”; “A description of the functional communication goals expected to be achieved and treatment options;”; “Rationale for selection of a specific device and any accessories;”; “Demonstration that the beneficiary possesses a treatment plan that includes a training schedule for the selected device;”; “The cognitive and physical abilities to effectively use the selected device and any accessories to communicate;”; “For a subsequent upgrade to a previously issued SGD, information regarding the functional benefit to the beneficiary of the upgrade compared to the initially provided SGD”; “The beneficiary’s medical condition is one resulting in a severe expressive speech impairment”; “The beneficiary’s speaking needs cannot be met using natural communication methods”; “Other forms of treatment have been considered and ruled out”; “The beneficiary’s speech impairment will benefit from the device ordered”; “A copy of the SLP’s written evaluation and recommendation have been forwarded to the beneficiary’s treating practitioner prior to ordering the device”; “The SLP performing the beneficiary evaluation may not be an employee of or have a financial relationship with the supplier of the SGD.”; “If one or more of the SGD coverage criteria 1-7 is not met, the SGD will be denied as not reasonable and necessary.”; “claims for more than one SGD will be denied as not reasonable and necessary”; “Alternative input devices are covered when a beneficiary is unable to use standard input devices.”; “Eye tracking, gaze interaction and electromyographic sensor accessories for speech generating devices are covered when furnished to individuals with a demonstrated medical need for such accessories.”; “If the SGD is denied as not reasonable and necessary, any related accessories will be denied as not reasonable and necessary.”; “A Standard Written Order (SWO) must be communicated to the supplier before a claim is submitted.”.
CGS Administrators and Noridian Healthcare Solutions, the Medicare durable medical equipment contractors, in CMS’s Medicare Coverage Database. Speech Generating Devices (SGD) - Policy Article, A52469 (version 28, effective October 1, 2024). Checked October 24, 2026.
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“Is appropriate for use in the home”; “For criterion 7, a device utilizing tablet, smartphone or computer hardware must be designed by the manufacturer to function solely as a speech generation device, as defined above, at the time of initial issue.”; “Medicare will reimburse for speech generating software only (HCPCS code E2511) when installed on a general computing device.”; “A carrying case (including shoulder strap or carrying handle, any type) (E2599) is a convenience item and is denied as non-covered.”; “Upgrades to speech generating devices and/or software programs that are provided within the 5 year useful lifetime of the device will be denied as statutorily non-covered.”; “For alternative input devices, there must be information in the SLP evaluation about why standard input access devices are unable to be used.”; “include all applicable speech generating software programs (whether they are on the device when shipped by the manufacturer or added by the supplier prior to delivery), batteries, battery chargers and AC adapters.”; “Replacement or upgrade of speech generating software loaded onto a covered speech generating device is not covered unless the replacement software is necessary due to a change in the patient’s condition, or in cases where the software has been lost, stolen, irreparably damaged, or has been in continuous use for the reasonable useful lifetime of 5 years.”; “Mounting systems and stands (E2512) are accessories that are needed to place the SGD, switches or other access devices within the reach of the beneficiary.”; “Ocular tracking device, any type, describes an SGD accessory used with an SGD or SGD software to allow a speech-impaired person to use his or her eyes to communicate.”; “Electronic components that allow the SGD to be operated by the drive control interface of a power wheelchair.”.
Medicaid.gov. Early and Periodic Screening, Diagnostic, and Treatment. Checked October 24, 2026.
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“provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid”; “States are required to provide any additional 1905(a) services that are coverable under the Federal Medicaid program and found to be medically necessary to treat, correct, or reduce illnesses and conditions discovered regardless of whether the service is covered in a state’s Medicaid plan.”; “It is the responsibility of states to determine medical necessity on a case-by-case basis.”; “States are required to furnish all 1905(a) Medicaid coverable, appropriate, and medically necessary services needed to correct and ameliorate health conditions”.
42 CFR. §440.70, Home health services (Medicaid). Checked October 24, 2026.
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“Paragraphs (b)(1), (2) and (3) of this section are required services and items that must be covered according to the home health coverage parameters.”; “On his or her physician’s orders or orders written by a licensed practitioner of the healing arts acting within the scope of practice authorized under State law, as part of a written plan of care for services described in paragraph (b)(3) of this section.”; “Medical supplies, equipment, and appliances suitable for use in any setting in which normal life activities take place”; “Equipment and appliances are items that are primarily and customarily used to serve a medical purpose, generally are not useful to an individual in the absence of a disability, illness or injury, can withstand repeated use, and can be reusable or removable. State Medicaid coverage of equipment and appliances is not restricted to the items covered as durable medical equipment in the Medicare program.”; “A beneficiary’s need for medical supplies, equipment, and appliances must be reviewed by a physician”; “acting within the scope of practice authorized under State law, annually.”; “States can have a list of preapproved medical equipment supplies and appliances for administrative ease but States are prohibited from having absolute exclusions of coverage on medical equipment, supplies, or appliances.”; “When denying a request, a State must inform the beneficiary of the right to a fair hearing.”; “Home health services cannot be limited to services furnished to beneficiaries who are homebound.”.
45 CFR. §147.150, Coverage of essential health benefits. “in the individual or small group market must ensure that such coverage includes the essential health benefits package”. Checked October 24, 2026.
HealthCare.gov. What Marketplace health insurance plans cover. Checked October 24, 2026.
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“All plans offered in the Marketplace cover these 10 essential health benefits”; “Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)”; “Specific services covered in each broad benefit category can vary based on your state’s requirements.”.
34 CFR. §300.105, Assistive technology (IDEA Part B). Checked October 24, 2026.
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“Each public agency must ensure that assistive technology devices or assistive technology services, or both, as those terms are defined in §§ 300.5 and 300.6, respectively, are made available to a child with a disability if required as a part of the child’s”; “On a case-by-case basis, the use of school-purchased assistive technology devices in a child’s home or in other settings is required if the child’s IEP Team determines that the child needs access to those devices in order to receive FAPE.”.
34 CFR. §300.154, Methods of ensuring services (IDEA Part B). Checked October 24, 2026.
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“A public agency may use the Medicaid or other public benefits or insurance programs in which a child participates to provide or pay for services required under this part”; “May not require parents to sign up for or enroll in public benefits or insurance programs in order for their child to receive FAPE under Part B of the Act;”; “May not require parents to incur an out-of-pocket expense such as the payment of a deductible or co-pay amount incurred in filing a claim for services provided pursuant to this part”; “Prior to accessing a child’s or parent’s public benefits or insurance for the first time”; “must obtain written, parental consent”; “a public agency may access the parents’ private insurance proceeds only if the parents provide consent”; “Inform the parents that their refusal to permit the public agency to access their private insurance does not relieve the public agency of its responsibility to ensure that all required services are provided at no cost to the parents.”.
Administration for Community Living. Assistive Technology (State Grant for Assistive Technology Program). Checked October 24, 2026.
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“The program provides one grant to each state, the District of Columbia, Puerto Rico, and the outlying areas”; “supports state efforts to improve the provision of assistive technology to individuals with disabilities of all ages”; “AT Demonstration activities provide opportunities for people to become familiar with specific types of AT by comparing and contrasting the functions and features of devices”; “AT Device Loan activities allow individuals to borrow AT for a limited time period to try out and determine if a device will meet their needs before a purchase is made.”; “AT Reutilization activities support the reuse of assistive technology that is no longer needed or used by its original owner and is acquired by a new owner at substantial cost savings.”; “AT State Financing activities support the purchase/acquisition of AT through financial loans or other initiatives”.
34 CFR. §361.48, Scope of vocational rehabilitation services for individuals with disabilities. “an assessment by personnel skilled in rehabilitation technology”; “Rehabilitation technology in accordance with the definition of that term in § 361.5(c)(45), including vehicular modification, telecommunications, sensory, and other technological aids and devices.”. Checked October 24, 2026.
38 CFR. §17.3230, Authorized items and services (VA prosthetic and rehabilitative items). Checked October 24, 2026.
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“VA will provide veterans eligible under § 17.3220 with the following items and services if VA determines that such items and services are needed under § 17.38(b), serve as a direct and active component of the veteran’s medical treatment and rehabilitation, and do not solely support the comfort or convenience of the veteran”; “Communication devices.”.
Communication Health Support Association, HelpingYouCommunicate.org (the page ASHA’s public AAC address, asha.org/public/speech/disorders/aac/, now opens). Augmentative and Alternative Communication (AAC) (consumer page, last reviewed May 8, 2026). Checked October 24, 2026.
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“Some people might need AAC only for a short time, like when they have surgery and can’t talk.”; “apps on tablets or smartphones”; “Children younger than 3 years old can start using AAC. There are no thinking skills, test scores, or other milestones that you need to reach before AAC can help.”; “People who use AAC can use both speech and AAC to talk to other people.”; “You can use your arms, feet, head, or eyes to use AAC. Your SLP can work with you and your occupational and physical therapists to help communicate.”; “Some AAC tools are covered by insurance, but some are not.”.
American Speech-Language-Hearing Association, for the National Joint Committee for the Communication Needs of Persons With Severe Disabilities. Funding for Communication Services and Supports (NJC guidance). Checked October 24, 2026.
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“Deciding which one(s) should be approached may be based on the person’s age, disability, or other factors (e.g. income; interest in employment).”; “This includes AAC devices - from "low tech" such as picture communication cards to "high tech" speech generating devices (SGDs).”; “A school cannot compel a family to use its private health insurance to acquire AAC devices”; “families may find it beneficial to cooperate with the school to fund or co-fund assistive technology equipment”; “if the school purchases the technology, it belongs to the school, but if private health insurance pays, it belongs to the beneficiary.”; “AAC devices/services for eligible children as long as they are medically necessary (even though they may be educationally necessary as well)”; “It is not permissible to delay access to needed technology pending approval from other funding sources.”; “schools may need to explore temporary access solutions (such as a district’s equipment inventory, an equipment loan program, or short-term rental) while waiting for more permanent funding solutions.”; “Currently, adults with disabilities in the United States do not have an entitlement to free therapeutic services or assistive technology.”; “Options for funding communication services and supports for adults may include state-administered programs like Medicaid, Home and Community-based Medicaid Waivers, Vocational Rehabilitation, or health insurance programs like Medicare or private health insurance.”; “Services/devices address the medical condition by attempting to restore lost function, forestall further functional decline, or provide an alternative means of performing the affected function.”; “health insurers define medical necessity in different ways.”; “Insurers most often will only fund AAC devices that qualify as "durable medical equipment"”; “Knowing the precise wording of each insurer’s definition can be important in wording the justification accordingly.”; “Some of these include training of communication partners, conducting an environmental inventory to identify needed vocabulary, and programming an AAC device.”; “Medicare may cover such services as device programming and training.”; “Although these services are critical, they may not be covered.”.
34 CFR. §300.324, Development, review, and revision of IEP (IDEA Part B). “Consideration of special factors. The IEP Team must”; “Consider whether the child needs assistive technology devices and services.”. Checked October 24, 2026.
34 CFR. §300.101, Free appropriate public education (FAPE) (IDEA Part B). “A free appropriate public education must be available to all children residing in the State between the ages of 3 and 21, inclusive”. Checked October 24, 2026.
34 CFR. §303.13, Early intervention services (IDEA Part C). Checked October 24, 2026.
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“Are provided at no cost, except, subject to §§ 303.520 and 303.521, where Federal or State law provides for a system of payments by families, including a schedule of sliding fees;”; “Communication development;”; “as identified by the IFSP Team”; “Assistive technology device means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of an infant or toddler with a disability.”.
Medicare.gov. Durable medical equipment (DME) coverage (what Part B covers). Checked October 24, 2026.
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“Expected to last at least 3 years”; “Medicare covers different kinds of DME in different ways.”; “Some items become your property after you’ve made a certain number of rental payments.”; “Part B covers medically necessary DME if your doctor or other health care provider orders it for use in your home.”; “Medicare will only pay for DME items if you get them from suppliers who are enrolled in Medicare.”; “After you meet the Part B deductible, you pay 20% of the Medicare-approved amount (if your supplier accepts assignment).”; “If a supplier participates in Medicare, they must accept assignment (which means, they can charge you only the coinsurance and Part B deductible for the Medicare-approved amount).”; “If a DME supplier doesn’t participate in Medicare or won’t accept assignment, you may be charged more.”.
Medicare.gov. Appeals in Original Medicare. “Before you start an appeal, ask your provider or supplier for any information to make your appeal stronger.”; “The first level of appeal in Original Medicare is called a Redetermination.”; “You must file your appeal by the date in the MSN.”. Checked October 24, 2026.
42 CFR. §422.101, Requirements relating to basic benefits (Medicare Advantage). Checked October 24, 2026.
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“Provide coverage of, by furnishing, arranging for, or making payment for, all services that are covered by Part A and Part B of Medicare”; “CMS’s national coverage determinations;”; “Written coverage decisions of local Medicare contractors with jurisdiction for claims in the geographic area in which services are covered under the MA plan.”.
Medicare.gov. Compare Original Medicare and Medicare Advantage. “Plans must cover all medically necessary services that Original Medicare covers.”; “You may need to get approval (prior authorization) from your plan before it covers certain services or supplies.”. Checked October 24, 2026.
Medicare.gov. Appeals in Medicare health plans. “must file an appeal within 65 days from the date on the initial denial notice sent by your plan”. Checked October 24, 2026.
42 CFR. §440.110, Physical therapy, occupational therapy, and services for individuals with speech, hearing, and language disorders (Medicaid). Checked October 24, 2026.
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“Physical therapy means services prescribed by a physician or other licensed practitioner of the healing arts”; “Occupational therapy means services prescribed by a physician or other licensed practitioner of the healing arts”; “for which a patient is referred by a physician or other licensed practitioner of the healing arts within the scope of his or her practice under State law. It includes any necessary supplies and equipment.”.
Medicaid.gov. Mandatory & Optional Medicaid Benefits. “States are required to provide all mandatory benefits under federal law. States may provide optional benefits if they choose to add them through the state plan process.”; “Home health services (1905(a)(7), 42 CFR 440.70 and 42 CFR 441.15)”; “Speech, hearing and language disorder services (1905(a)(11), 42 CFR 440.110(c))”. Checked October 24, 2026.
HealthCare.gov. Preauthorization (glossary). “A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary.”; “Preauthorization isn’t a promise your health insurance or plan will cover the cost.”. Checked October 24, 2026.
HealthCare.gov. Internal appeals. “You must file your internal appeal within 180 days (6 months) of receiving notice that your claim was denied.”. Checked October 24, 2026.
34 CFR. §300.6, Assistive technology service (IDEA Part B). Checked October 24, 2026.
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“The evaluation of the needs of a child with a disability, including a functional evaluation of the child in the child’s customary environment;”; “Selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices;”; “Training or technical assistance for a child with a disability or, if appropriate, that child’s family”.
34 CFR. §300.507, Filing a due process complaint (IDEA Part B). Checked October 24, 2026.
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“A parent or a public agency may file a due process complaint on any of the matters described in § 300.503(a)(1) and (2) (relating to the identification, evaluation or educational placement of a child with a disability, or the provision of FAPE to the child).”; “The due process complaint must allege a violation that occurred not more than two years before the date the parent or public agency knew or should have known about the alleged action that forms the basis of the due process complaint, or, if the State has an explicit time limitation for filing a due process complaint under this part, in the time allowed by that State law”.
34 CFR. §361.42, Assessment for determining eligibility and priority for services (State Vocational Rehabilitation Services program). Checked October 24, 2026.
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“A determination by qualified personnel that the applicant’s physical or mental impairment constitutes or results in a substantial impediment to employment for the applicant”; “the applicant requires vocational rehabilitation services to prepare for, secure, retain, advance in, or regain employment”; “A determination by a qualified vocational rehabilitation counselor employed by the designated State unit”.
34 CFR. §361.57, Review of determinations made by designated State unit personnel. “The right to obtain review of State unit determinations that affect the provision of vocational rehabilitation services through an impartial due process hearing”. Checked October 24, 2026.
U.S. Department of Veterans Affairs, Rehabilitation and Prosthetic Services. VA Speech-Language Pathology. Checked October 24, 2026.
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“Speech-language pathologists are specialists in providing recommendations for a wide range of technology for individuals that are unable to speak”; “Examples of assistive technology include a picture board paired with a laser pointer, utilization of applications (apps) for smart phones for a tablet, or a device that produces computerized speech accessed by an eye gaze switch.”; “Progressive neurological disorders such as Parkinson’s Disease, Multiple Sclerosis, Amyotrophic Lateral Sclerosis (ALS)”.
38 CFR. §17.3220, Eligibility (VA prosthetic and rehabilitative items). Checked October 24, 2026.
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“The veteran is enrolled under § 17.36 or exempt from enrollment under § 17.37(a) through (c)”; “If a VA provider or an eligible entity or provider as defined in § 17.4005 prescribes an item or service for the veteran, the veteran is considered to otherwise be receiving care or services under chapter 17 of title 38 U.S.C.”.
U.S. Department of Veterans Affairs. Patient Advocate (Veterans Health Administration page). “The Patient Advocacy Program is for all veterans and their families who receive care at VA health care facilities.”; “If you need help getting care or getting your problems resolved, talk to the Patient Advocate at your VA medical center.” Checked October 24, 2026.
Centers for Medicare & Medicaid Services. FFS ABN (the Advance Beneficiary Notice of Noncoverage). Checked October 24, 2026.
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“is issued by providers (including independent laboratories, home health agencies, and hospices), physicians, practitioners, and suppliers to Original Medicare (fee for service - FFS) beneficiaries in situations where Medicare payment is expected to be denied.”; “The ABN is issued in order to transfer potential financial liability to the Medicare beneficiary in certain instances.”.
Medicare.gov. Medicare costs (the amounts for 2026). “Part B costs: What you pay in 2026”; “$283 before Original Medicare starts to pay. You pay this deductible once each year.”; “Usually 20% of the cost for each Medicare-covered service or item after you’ve paid your deductible”. Checked October 24, 2026.
Centers for Medicare & Medicaid Services. Medicare Claims Processing Manual, Chapter 20, Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (§30.1, Inexpensive or Other Routinely Purchased DME, Rev. 4027, effective October 1, 2018). Checked October 24, 2026.
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“For this type of equipment, A/B MACs (A), (B), or (HHH), and DME MACs pay for rentals or lump-sum purchases.”; “the total payment amount may not exceed the actual charge or the fee schedule amount for purchase”; “Effective October 1, 2015, this category also includes speech generating devices and accessories necessary for the effective use of speech generating devices.”.
45 CFR. §156.115, Provision of EHB. “Cover health care services and devices that help a person keep, learn, or improve skills and functioning for daily living (habilitative services).”; “Do not impose limits on coverage of habilitative services and devices that are less favorable than any such limits imposed on coverage of rehabilitative services and devices”. Checked October 24, 2026.
HealthCare.gov. Medically necessary (glossary). “Health care services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine.”. Checked October 24, 2026.
34 CFR. §300.5, Assistive technology device (IDEA Part B). “Assistive technology device means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of a child with a disability.”. Checked October 24, 2026.
34 CFR. §104.33, Free appropriate public education (Section 504 regulations). Checked October 24, 2026.
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“the provision of an appropriate education is the provision of regular or special education and related aids and services”; “the provision of a free education is the provision of educational and related services without cost to the handicapped person or to his or her parents or guardian”.
34 CFR. §303.520, Policies related to use of public benefits or insurance or private insurance to pay for Part C services (IDEA Part C). Checked October 24, 2026.
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“The State may not use the private insurance of a parent of an infant or toddler with a disability to pay for part C services unless the parent provides parental consent”; “May not require a parent to sign up for or enroll in public benefits or insurance programs as a condition of receiving part C services”.
U.S. Department of Education, Rehabilitation Services Administration. Vocational Rehabilitation State Grants (program description). “so that they may prepare for and engage in competitive integrated employment or supported employment and achieve economic self-sufficiency”; “State VR agencies may also provide pre-employment transition services to students with disabilities who are potentially eligible for the VR program.”. Checked October 24, 2026.
34 CFR. §361.5, Applicable definitions (State Vocational Rehabilitation Services program). Checked October 24, 2026.
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“Rehabilitation technology means the systematic application of technologies, engineering methodologies, or scientific principles to meet the needs of, and address the barriers confronted by, individuals with disabilities in areas that include education, rehabilitation, employment, transportation, independent living, and recreation. The term includes rehabilitation engineering, assistive technology devices, and assistive technology services.”.
34 CFR. §361.53, Comparable services and benefits. Checked October 24, 2026.
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“the State unit must determine whether comparable services and benefits, as defined in § 361.5(c)(8), exist under any other program and whether those services and benefits are available to the individual”; “are exempt from a determination of the availability of comparable services and benefits under paragraph (a) of this section”; “Rehabilitation technology, including telecommunications, sensory, and other technological aids and devices.”.
38 CFR. §17.3210, Definitions (VA prosthetic and rehabilitative items). “Communication device means an item that compensates for a communication deficiency and allows participation in daily communication activities, including but not limited to picture or symbol communication boards and an electro larynx.”. Checked October 24, 2026.
45 CFR. §149.610, Requirements for provision of good faith estimates of expected charges for uninsured (or self-pay) individuals. Checked October 24, 2026.
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“Health care provider (provider) means a physician or other health care provider who is acting within the scope of practice of that provider’s license or certification under applicable State law”; “who does not seek to have a claim for such item or service submitted to such plan or coverage”; “Convening providers and convening facilities shall consider any discussion or inquiry regarding the potential costs of items or services under consideration as a request for a good faith estimate”; “When a good faith estimate is requested by an uninsured (or self-pay) individual: Not later than 3 business days after the date of the request.”.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your individual situation.

AAC device funding for children and adults