SoonerCare – Provider for Speech-Generating Devices

Oklahoma ABLE Tech collaborates with the Oklahoma Health Care Authority (OHCA) as durable medical equipment (DME) provider of vending iPads, apps, and durable cases as speech-generating devices (SGD) to eligible members.

The following requirements are needed to request ANY speech-generating device from SoonerCare - including those from Apple (iPad and app), Prentke Romich Company (PRC), Tobii Dynavox, and Saltillo, etc.

Requirements include:

AAC Evaluation conducted by a licensed SLP (completed within the last 6 months). Please include the SLP’s phone number and email address. Link to OHCA Guidelines for Evaluation for Speech Generating Device
Video documentation demonstrating functional use (preferably on a flash drive that won't be returned). The entire video should be no more than 5-8 minutes. The accepted file type is an MP4.
Signed and dated order, referral, or prescription stating device name, communication app if an iPad, and specific accessories (straps, key-guards, cases, etc.) written by an OHCA-contracted qualified medical professional (MD, DO, CNP, APRN). The order must be signed within 90 days of the evaluation.
Letter of medical necessity if the statement of medical necessity is not in the prescription (See below a sample of separate letter of medical necessity; may be included on the prescription).
Copy of most recent visit with the doctor where expressive communication disorder (or nonverbal) is noted (visit on notes must be within a calendar year of the authorization request).
Release of Liability form signed by the parent/guardian (downloadable form below).
Copy of private insurance card, front and back, if applicable
The completed HCA-61 Therapy Prior Authorization Request form if submitted with the evaluation for Speech Generating Device.

The Fine Print - What You Need to Know

SoonerCare approves devices for persons up to age 21.
The evaluation must include trials for a minimum of three different devices/applications.
The request MUST be submitted by a licensed speech pathologist to Oklahoma ABLE Tech.
Approved requests will Include the following:
- An iPad
  - iPad 8^th generation, 10.2-inch screen, 64 GB, and any color
  - iPad Air 4^th generation, 10.9-inch screen, 64 GB, and any color
- The appropriate communication application
- A durable case (Ex. SEYMAC, ZenRich, Otterbox, etc.)
CPT/HCPCS Code for the iPad, app, and case is E2599 - Accessory for Speech-Generating Device, Not Otherwise Classified
SoonerCare is a payor of last resort. If the SoonerCare member has insurance coverage from more than one entity, the other entity(s) must be billed first for the SGD. An Explanation of Benefits (EOB) letter must be presented to SoonerCare before they will pay the balance total for the SGD.

Need Assistance with Report Writing?

For assistance in writing the report and to access the forms needed, please visit AAC Funding (Your PRC and Saltillo Funding Source). This resource is designed to help people with requests for PRC and Saltillo equipment; however, the final report can be customized for any speech-generating device.