CPT code 92507
CPT code 92507 is one of several five-digit codes that therapists attach to documentation when billing therapy services. Being familiar with some of the most commonly used CPT codes in your field can make the billing side of your practice a little easier.
The American Medical Association maintains and owns the copyright for CPT codes, which stands for Current Procedural Terminology.
If you’re billing a therapy session or evaluation for a client who has Medicare and Medicaid, it’s required that you attach the appropriate CPT code to your documentation. Many private insurance companies also frequently adopt CPT codes.
For speech therapists, CPT code 92507 is one of the most important codes to know and is used for ‘Treatment of Speech, language, voice, communication, and/or auditory processing disorder; individual.’
We’ll break down who can bill this code, what services it includes, when to use the code, and how to bill CPT 92507 correctly. We’ll also dive into reimbursement and some recent, need-to-know updates surrounding this code.
CPT code 92507 should be used by speech therapists when billing an individual treatment session. The session would be focused on addressing treatment goals that target skills in the areas of speech, language, voice, communication and/or auditory processing disorder.
According to American Speech Language Hearing Association (or ASHA) “services for training and modification in the use of a voice prosthetic” are also coded using CPT code 92507.
Only a speech-language pathologist can bill using CPT code 92507. Even though this code includes treatment of auditory processing disorders, audiologists cannot bill this code, according to AMA guidelines.
Some SLPs may struggle to find the most appropriate code for their services at times. ASHA encourages clinicians to use the “best” code to describe the services they provide. As with all CPT codes, an SLP can only bill a particular client using the 92507 CPT code once per day.
Here are some examples of areas targeted in a treatment session in which the provider can attach the 92507 CPT code to documentation and billing:
- Articulation (for example, goals that include targeting a client’s production of a specific sound).
- Phonology (eliminating a Phonological Process, such as fronting).
- Expressive language skills (for example, working with a 2 year old with an expressive language delay on increasing his/her vocabulary).
- Receptive language skills (such as with an adult client diagnosed with receptive Aphasia).
- Auditory Processing Disorder (for example, a therapy session in which the SLP works on the client’s listening comprehension skills or an APD strategy, such as identifying key words within sentences).
How to use the 92507 CPT Code
CPT codes can be separated into 2 categories: timed and service-based.
CPT code 92507 is service-based. This means that the code is intended to be used for a specific procedure that matches its description, regardless of how long the treatment session lasted.
Follow these steps to correctly bill for the CPT code 92507:
- Refer to the CPT manual from the AMA to ensure CPT code 92507 is the appropriate code for you to use for a specific session.
- Complete documentation for a treatment session (for example, in the form of a SOAP note).
- Attach CPT code 92507.
The SLP’s documentation for the treatment session should reflect that the client has a treatment diagnosis related to the description of CPT code 92507. The goals targeted within the session should also relate to the areas outlined in this code’s description.
Here’s how to avoid some common errors when using the CPT code 92507, and reduce the likeliness of a reimbursement denial:
- Use the code for treatment, not evaluation.
- Do not report CPT code 92507 on the same day as 97129 and 97130 codes for a client, which refer to sessions focusing on cognitive functioning.
- Do not use for treatment of an Augmentative Alternative Communication (AAC) device (a treatment session for this would be coded under 92609).
ASHA’s Medicare Fee Schedule for Speech-Language Pathologists is a helpful source that can guide SLPs on which CPT code to use and current reimbursement rates.
The national fee for 2023 for CPT code 92507 is $75.38.
For private insurance payors, reimbursement rates vary according to specific plans. Determining whether the client’s insurance plan covers speech therapy (including sessions in which CPT code 92507 is billed) for their specific diagnosis is important. Verify this information, and encourage your client to do so as well, prior to initiating services to maximize reimbursement for this code.
Some private providers who do not accept insurance choose to set their prices for services to be close to Medicare or Medicaid reimbursement rates.
Updates to CPT codes are performed periodically, and it’s important for clinicians to stay current on changes that may affect the way they bill for services.
2023 changes affecting CPT Code 92507
- A new CPT code was added; 0770T Virtual reality technology to assist therapy.
- This code is intended to be listed separately in addition to code for the primary procedure. CPT 0770T can only be used in conjunction with a specified list of other CPT codes (listed here). CPT code 92507 is one of the approved codes to be listed with 0770T.
- CPT code 92507 was added to Appendix P in the CPT codebook published by the AMA. This states that CPT code 92507 can be reported with the modifier -95 (synchronous audio-visual telehealth service), according to ASHA.
Failure to comply with current requirements or not using the most appropriate CPT code can result in insurance denials or delayed reimbursement for services.
Stay up to date with changes to the 92507 CPT code by checking the AMA’s CPT codebook when updates are made. The AMA updates CPT codes annually and are effective for use on January 1st of each year.
CPT code 92507 is one of the most important, comprehensive codes for speech language pathologists. By staying current on what types of treatment the code includes and when to use it, providers can have more assurance that they’re following AMA guidelines and will receive reimbursement for services.
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