We bring certified, mobile FEES evaluations directly to your facility — so your patients receive timely, accurate dysphagia diagnostics without leaving the building.
Research shows the significant impact of undetected dysphagia in elderly patients — and the importance of timely instrumental assessment.
Difficulty swallowing food, liquids, or medications
Complaints of food feeling "stuck" in their throat
Fatigue with meals
Constantly clearing their throat or coughing when eating and drinking
Weight loss, a new onset of, or a chronic dehydration / malnutrition diagnosis
Difficulty coordinating breathing and swallow timing
Excessive or unmanaged secretions
Frequent or recurrent respiratory illnesses (pneumonia, bronchitis, or pneumonitis)
Progressive neurological diagnoses (Parkinson's Disease, M.S., Huntington's Chorea)
Trach or vent dependent
Difficulty with head or trunk control
Anatomical deviations to the larynx or pharynx
Stroke with confusion or hemiparesis
Dementia
Following these steps ensures a smooth evaluation experience for your patients and staff.
Our clinicians work efficiently and collaboratively with your team, keeping patients comfortable throughout the process.
Our clinician arrives with all necessary equipment and conducts a thorough review of the patient's medical chart before the evaluation begins.
We discuss the FEES procedure with the patient and complete any additional patient preparation work needed to ensure comfort and accuracy.
The endoscopist passes the endoscope transnasally and guides your facility's representative through the PO presentations. Both the patient and facility representative may observe the video in real time.
During the FEES, we assess compensatory strategies and positioning techniques to determine the safest and most appropriate diet for your patient.
Our clinician will then review the video and complete a detailed diagnostic report, including PO recommendations, strategies, therapy suggestions, and potential referral recommendations. An invoice for billed services will follow.
Our clinician will discuss results with an appropriate facility representative and collaborates with your SLP on treatment planning.
A quick-reference billing guide for facility administrators, SLPs, and Directors of Rehabilitation. Select a topic below.
BDD contracts directly with your facility at a flat per-procedure rate. We do not bill residents or any insurance plan. Our contract for FEES services is between BDD and the facility — for services and payment.
All insurance billing is the facility's responsibility. Because a FEES evaluation is a therapy service performed by a therapist under the roof of your facility, consolidated billing rules apply.
FEES is a swallowing evaluation performed by a therapist in your facility. Accordingly, the facility is the billing provider for any insurance reimbursement — not BDD.
Under some insurance plans, the facility may capture reimbursement for a portion of the FEES cost (e.g. Medicare B, MCO/HMO — may require prior authorization).
Following each FEES exam, a detailed receipt is uploaded alongside the FEES report to your shared facility folder. This is accessible for 60 days by your facility SLP and/or DOR to download at any time.
Your facility SLP may bill dysphagia treatment time under CPT 92526 in your EHR system. Facilities may also add BDD SLPs to your EHR to input CPT 92612 minutes directly — ensuring FEES services are captured in your month-end billing and utilization reports.
To bill insurance, the facility must add CPT 92612 to their:
The supporting ICD-10 code for oropharyngeal dysphagia is:
R13.12
Oropharyngeal Dysphagia
FEES is typically treated the same as any rehab evaluation by private insurance plans. If the plan requires pre-authorization for therapy evaluations, the facility may need to request pre-auth for the FEES swallowing evaluation before scheduling.
The cost of the procedure is subtracted from the resident's day rate. It is not reimbursed separately under Medicare Part A consolidated billing rules.
Therapy procedures including FEES are billable by CPT code. The 2025 Physician Fee Schedule averages $205 reimbursement for CPT 92612 in New England.
The cost of the procedure is subtracted from the resident's day rate. It is not reimbursed separately under managed care consolidated billing arrangements.
The cost of the procedure is subtracted from the resident's day rate. It is not reimbursed separately under Medicaid consolidated billing rules.
Treated the same as any rehab evaluation. If pre-authorization is required for therapy evaluations, request pre-auth for the FEES swallowing evaluation. Facility bills the resident's plan directly.
Fiberoptic endoscopic evaluation of swallowing by cine or video recording. This is the primary procedure code for the FEES evaluation itself. Billed by the facility on the UB-04 or 837-I.
Treatment of swallowing dysfunction and/or oral function for feeding. The facility SLP may bill this for dysphagia treatment time in your EHR system.
Evaluation of oral and pharyngeal swallowing function. If billed on the same day as CPT 92612, Modifier *59 is required on 92612 to identify it as a separate and distinct procedure.
Oropharyngeal Dysphagia — the supporting diagnosis code used when billing insurance for a FEES evaluation. Include on the UB-04 or electronic claim.
Have questions about FEES evaluations or partnering with Bayside Dysphagia Diagnostics? We've answered the most common ones below.
FEES stands for Fiberoptic Endoscopic Evaluation of Swallowing. It is a diagnostic procedure performed by a specially trained Speech-Language Pathologist (SLP). A thin, flexible endoscope is gently passed through the nose to visualize pharyngeal and laryngeal structures during the swallow. The procedure allows clinicians to directly observe the safety and efficiency of the swallow, including whether food or liquid is entering the airway (aspiration) which is often missed during bedside assessments.
FEES can be performed within your facility - usually within 1-3 days - with no transport required. FEES uses no radiation, can be performed at bedside in any position, and allows real-time assessment using actual food and liquid textures from the patient's diet. Results are available immediately, and the procedure is generally well-tolerated.
A referring physician must provide a written order for the FEES procedure (CPT codes 92612 and 92526). The need for the evaluation is typically identified by a Speech-Language Pathologist, Registered Nurse, Dietitian, or Physician based on clinical signs of dysphagia such as coughing during meals, unexplained weight loss, recurrent aspiration pneumonia, or a patient's self-reported difficulty swallowing.
FEES is a minimally invasive, well-tolerated procedure with an excellent safety record. It is performed by our CCC-SLP certified clinicians following strict infection control protocols. Potential side effects are rare but may include mild nasal discomfort or, very rarely, a vasovagal response. We review each patient's medical history prior to the evaluation and will advise if any contraindications exist.
A typical FEES evaluation takes approximately 30–45 minutes from setup to completion, including chart review, patient preparation, the procedure itself, and equipment disinfection. Results and preliminary recommendations are shared with your facility representative immediately following the evaluation. A full written report is provided shortly thereafter.
Bayside Dysphagia Diagnostics provides mobile FEES evaluations throughout Cape Cod and the South Shore regions of Massachusetts, including nursing homes, skilled nursing facilities (SNFs), long-term care facilities, and assisted living communities. If you're unsure whether your facility is within our service area, please contact us and we'll be happy to confirm.
Bayside Dysphagia Diagnostics was founded out of a need to close the gap in the continuum of care for dysphagia patients needing an instrumental swallowing assessment in a timely manner in a skilled nursing facility, assisted living facility, or long-term care setting.
Melanie Reynolds is a certified Speech-Language Pathologist (SLP) through the American Speech-Language-Hearing Association (ASHA) and is the founder of Bayside Dysphagia Diagnostics. She has over 25 years of experience with a variety of populations in inpatient and outpatient rehabilitation as well as acute inpatient hospital settings. Melanie specializes in dysphagia management in complex medical and head and neck cancer patients.
She is proficient with over 20 years of experience performing both Modified Barium Swallowing evaluations and Fiberoptic Endoscopic Swallowing evaluations. She has taught FEES training courses, as well as served as a guest lecturer at Boston University Sargent College. Melanie has conducted and published research in areas of post-extubation dysphagia, rare neurological conditions, and the importance of instrumental swallowing evaluations in effectively evaluating and treating dysphagia.
Contact our team today to sign a Service Agreement, schedule your first evaluation, or simply learn more about how Bayside Dysphagia Diagnostics can support your patients.
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If you need to reschedule or cancel, please contact us as soon as possible. Cancellations made with less than 24 hours' notice due to non-emergent circumstances may be subject to a cancellation fee. We understand the unpredictable nature of skilled nursing environments and work with you in good faith.