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More information on this topic provided by asha.org:

Medical Necessity for Audiology and Speech-Language Pathology Services

Health plans, both public and private, cover services that are considered medically necessary. However, the definition of medical necessity can vary from payer to payer. Although there may not be one standard or generally accepted definition for medical necessity, the following information can help support arguments that speech, language, and hearing services meet medical necessity criteria.

How Is Medical Necessity Defined?

Paul Keckley, a health economist and policy expert with extensive experience in health services research in the private sector and academic medicine, writes in a  blog post "Medical necessity means something slightly different in every part of the health care industry. Varied definitions and interpretations are used by providers, physicians, courts, pharmacy benefits managers, government insurers, private insurers, and consumers."

Medicare defines medically necessary as "health-care services or supplies needed to prevent, diagnose, or treat an illness, injury, condition, disease, or its symptoms, and that meet accepted standards of medicine."

Under the Affordable Care Act (ACA), health insurers and group health plans must provide clear, consistent, and comparable information about their health plan benefits and coverage. This information is published in documents called the Summary of Benefits & Coverage and Uniform Glossary of Medical Terms. The Uniform Glossary of Medical Terms[PDF] provides the following definition for medically necessary:

Health care services or supplies needed to prevent, diagnose or treat an illness, injury, condition, disease or its symptoms, including habilitation, and that meet accepted standards of medicine.

This definition is particularly relevant for speech, language, and hearing services because children's needs are often habilitative"”rather than rehabilitative"”in nature.