Speech therapy CPT Codes and coding and billing of services aren’t necessarily the areas that many SLPs learn about during their education and training. Nor do many speech language pathologists get particularly excited to tackle figuring out how to report them on documentation.
While differentiating codes like 92507, 92521, and 92526 can sound overwhelming to therapists, it’s crucial for them to be familiar with how to code and bill services. That way, SLPs can easily and accurately bill procedures to ensure they’ll be reimbursed by Medicaid, Medicare, and private insurance companies.
The first step? Understanding what speech therapy CPT codes are and how they’re used by speech therapists.
What are speech therapy CPT codes?
SLPs working in various settings are likely to have seen and used speech therapy CPT codes as part of their documentation to charge for procedures like treatment sessions and evaluations. So, what are CPT codes?
CPT stands for Current Procedural Terminology and is part of a system that reports different services provided. The CPT system is copyrighted and maintained by the American Medical Association. CPT codes all have five digits. It’s required that one of these codes is attached to documentation when billing Medicare and Medicaid. The codes are also frequently adopted by other payers such as private insurances.
Timed vs. service-based CPT Codes
Unlike CPT codes used for physical therapy and occupational therapy, most speech therapy CPT codes are service-based. This means that the code is reported one time based on the procedure the SLP completed, regardless of how long the appointment was.
Some speech therapy CPT codes are time-based. This means that more than one code, or a certain number of units of a given code, might be required for particular services (like the first hour of an evaluation for a speech generating device).
Top speech therapy CPT codes
Comprehensive lists of all of the speech therapy CPT codes related to speech-language pathology services are available through ASHA. ASHA also has an extensive list of CPT codes through their guidelines on Medicare CPT coding rules for SLP services.
Here is a list of the most commonly used speech therapy CPT Codes that can easily be referenced for SLPs needing to navigate through billing and coding.
Treatment of Speech, language, voice, communication, and/or auditory processing disorder; individual.
This code should be used by SLPs for billing an individual session that was focused on a client’s speech and language skills. The code is untimed, meaning it is used one time regardless of the length of the session.
Medicare rules include training and modification of voice prosthetics in this code. And it can also be used when billing a session focused on auditory rehabilitation.
Evaluation of speech sound production with evaluation of language comprehension and expression.
This type of evaluation includes an assessment of both speech and language skills. Speech production skills include articulation, apraxia, dysarthria, and the use of phonological processes).
Language refers to both receptive and expressive language.
Evaluation of speech sound production.
This evaluation includes an assessment of both speech and language skills. Speech production skills include articulation, apraxia, dysarthria, and the use of phonological processes).
Language refers to both receptive and expressive language. SLPs should be sure to differentiate this from the CPT code 92522, which refers to an evaluation of speech sound production only.
Evaluation of speech fluency.
This code may be used during an evaluation for fluency disorders, including stuttering or cluttering.
A language sample would likely be taken, which the SLP analyzes to compute the percentage of syllables stuttered and/or the presence of any concomitant/secondary behaviors.
Evaluation of oral and pharyngeal swallowing function and includes an assessment of the client’s swallowing abilities at both the oral and pharyngeal level of swallowing.
Depending on the client’s age and the concerns, different consistencies of foods and liquids may be presented.
The SLP assesses and identifies areas of concern or the presence of dysphagia (swallowing difficulty).
Treatment of swallowing dysfunction and/or oral function for feeding.
This code would be used for a treatment session that addresses a client’s dysphagia, including babies with difficulty drinking from a bottle due to impairments in oral motor function or swallowing.
It can also be used to bill treatment sessions with children or adults requiring modified diets due to dysphagia.
Evaluation for prescription of speech-generating AAC device; first hour.
This is one of the few timed CPT codes for Speech Therapists.
This code should be used for the first 60 minutes of an evaluation for an AAC device (speech generating device, or SGD). If the appointment exceeds 1 hour, add-on codes should be used. 92608 should be used for each additional 30 minutes of the session.
Evaluation of auditory rehabilitation status, 1st hour.
It may be tied to an evaluation that was completed to determine if the client is a candidate for a cochlear implant or other surgically implanted hearing device.
This code could also be used for an evaluation post surgical intervention (for example, to measure skills after a client has received cochlear implants).
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