Fiberoptic Endoscopic Evaluation of Swallowing

Flexible Endoscopic Evaluation of Swallowing (FEES) is a safe and well tolerated procedure which examines the structure and function of the aerodigestive tract, specifically swallowing. The procedure is used to determine the nature of the swallowing problem and helps guide decisions regarding diet recommendations, quality of life, and risk factors for developing aspiration pneumonia.

During the test, a small flexible endoscope is passed along the floor of the nasal passage into the hypopharynx. The patient is asked to complete a variety of simple tasks so that certain structures can be viewed during movement. Next, liquids of various consistencies and foods of different textures are administered to determine the function of the swallowing system. Strategies including postural changes and behavioral strategies are tested to determine whether or not they are effective to protect the airway.

Our services are mobile so we come to you. This test can be completed while in bed, in a wheelchair, or at the kitchen table. In a facility, it can be completed in a hospital bed or in a resident’s room.

We provide FEES to rehabilitation hospitals, skilled nursing facilities, assisted living facilities, outpatient rehabilitation clinics, long term acute care hospitals and physician clinics (e.g., ENT, GI, and Pulmonology offices). We are based in Madison, WI and our mobile capabilities allow us to serve your facility in Dane county and beyond.

A FEES can be completed with anyone showing signs or symptoms of swallowing problems (dysphagia).

This includes patients with feeding tubes (NG, PEG), dementia or other cognitive impairments, patients on isolation precautions, supplemental oxygen and ventilator dependence, tracheostomy tubes and speaking valves, or a variety of other types of medically complex patients.

There are some patients who may not be ideal candidates including those with bilateral nasal obstruction, severe nose bleeds, or maxillary and nasal fractures.

For Individuals: We charge private pay rates as an outpatient provider. We can bill select insurances and Medicare Part B.

For Facilities: the FEES procedure is considered a speech language pathology therapy service using CPT Code 92612. Speech pathology services fall under billing rules as part of the Balanced Budget Act of 1997. If a FEES procedure is completed in the subacute setting with consolidated billing, the facility is responsible for payment to Madison Speech Therapy directly. The facility then bills the patient's fiscal intermediary for reimbursement for the procedure per CMS guidelines.

For Individuals: Contact us by email or phone to set up a free 15-minute phone consultation.

For Facilities: Contact us by email or phone and we will set up a meeting with you or a representative from your facility. We will discuss the contractual agreement for our services.

Medicare does not reimburse FEES completed in the home for outpatients. We can serve you in our Madison office location within one week.