Dedicated Device – What’s That?

Your funding source (e.g., private insurance, Medicare, or Medicaid) requires an AAC device to be a “dedicated device” for it to be covered.

Your SLP recommends trialing a “dedicated device”.

What exactly is a dedicated device?!?

Things are slowly starting to change, but the short answer is that a “dedicated device” is one that is designed and made by a specialized company solely for the purpose of providing a means of communication to individuals who need augmentative-alternative communication (AAC) support. Non-dedicated devices are electronic devices you can buy “off the shelf” and add software or apps to so they function as AAC systems.

Additional differences include:

Dedicated AAC

• designed / made only to provide a means of communication
• considered medically necessary
• more likely to be covered by insurance / Medicare / Medicaid
• tend to be more expensive
• usually have more training, repair services, and tech support offered
• tend to be more durable

Non-Dedicated AAC

• commercially available devices (e.g., iPad, smartphone, laptop) with AAC software or app added
• not designed for “medical” use
• can have easy access to other features and used for more than direct communication (e.g., camera, social media, other apps)
• tend to be less expensive
• easier to purchase

Examples:

dedicated device: Accent 1400 (from PRC, starting at $7595.00) [photo: prentrom.com]

non-dedicated device: iPad (starting at $329.00) with Speak for Yourself AAC app ($299.99) [photo: NWACS]

Requirements by private insurance companies and other funding sources vary from plan to plan, so you need to check directly with your funding source.

In Washington State, WAC 182-543-3400 specifies what communication devices/speech-generating devices (SGDs) are covered by WA Medicaid.

This 2015 Final Decision Memorandum found on the Centers for Medicare & Medicaid Services (CMS) website specifies:

Speech generating devices are considered to fall within the durable medical equipment benefit category established by § 1861(n) of the Social Security Act. They are covered for patients who suffer from a severe speech impairment and have a medical condition that warrants the use of a device based on the following definitions.

Speech generating devices are defined as durable medical equipment that provides an individual who has a severe speech impairment with the ability to meet his or her functional, speaking needs. Speech generating devices are speech aids consisting of devices or software that generate speech and are used solely by the individual who has a severe speech impairment. The speech is generated using one of the following methods:

* digitized audible/verbal speech output, using prerecorded messages;

* synthesized audible/verbal speech output which requires message formulation by spelling and device access by physical contact with the device-direct selection techniques;

* synthesized audible/verbal speech output which permits multiple methods of message formulation and multiple methods of device access; or

* software that allows a computer or other electronic device to generate audible/verbal speech.

Other covered features of the device include the capability to generate email, text, or phone messages to allow the patient to “speak” or communicate remotely, as well as the capability to download updates to the covered features of the device from the manufacturer or supplier of the device.

As long as the speech-generating device is limited to use by a patient with a severe speech impairment and is primarily used for the purpose of generating speech, it is not necessary for a speech-generating device to be dedicated only to speech generation to be considered DME. Computers and tablets in general are 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 because such services or modifications could be used for non-medical equipment such as standard phones or personal computers. In addition, specific features of a speech generating device that are not used by the individual who has a severe speech impairment to meet his or her functional speaking needs are not covered. This would include any computing hardware or software not necessary to allow for generation of audible/verbal speech, email, text or phone messages, such as hardware or software used to create documents and spreadsheets or play games or music, and any other function a computer can perform that is not directly related to meeting the functional speaking communication needs of the patient, including video communications or conferencing. These features of a speech generating device do not fall within the scope of § 1861(n) of the Social Security Act and the cost of these features are the responsibility of the beneficiary.

Related Resources

• See our curated list of companies offering dedicated devices
• See our curated list of developers offering communication apps for non-dedicated devices