For Dates of Service Before January 1, 2020

Speech and Language Pathology Procedure Codes

Allowable SLP services are identified by the allowable CPT procedure codes listed in the following table.

Note: All codes listed in this chart, if billed with an applicable POS code, are eligible for natural environment enhanced reimbursement. Providers may not submit claims for services for less than eight minutes. Most procedure codes for SLP services do not have a time increment indicated in their description. Except as previously noted, a quantity of "1" indicates a complete service. The daily service limitation for these codes is one.

Procedure Code Description Billing Limitations ForwardHealth Coverage Criteria
31575 Laryngoscopy, flexible; diagnostic   Use this code if the speech-language pathologist actually inserts a laryngoscope. Do not use this code if the speech-language pathologist is providing an analysis and does not insert the laryngoscope; instead, use code 92506 or 92610, as appropriate. For treatment, use 92507 or 92526, as appropriate. This service is to be performed according to the ASHA Code of Ethics and ASHA Training Guidelines for Laryngeal Videoendoscopy/Stroboscopy.
31579 Laryngoscopy, flexible or rigid telescopic, with stroboscopy   Use this code if the speech-language pathologist actually inserts a laryngoscope. Do not use this code if the speech-language pathologist is providing an analysis and does not insert the laryngoscope; instead, use code 92506 or 92610, as appropriate. This service is to be performed according to the ASHA Code of Ethics and ASHA Training Guidelines for Laryngeal Videoendoscopy/Stroboscopy.
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder   This code should be used for therapy services that address communication/cognitive impairments, voice prosthetics, and auditory rehabilitation.
92507 + UC* Treatment of speech, language, voice, communication, and/or auditory processing disorder   Use this code for aural rehabilitation following a cochlear implant.
92508 group, two or more individuals   "Group speech/language pathology treatment" means the delivery of SLP treatment procedures limited to the areas of expressive language, receptive language, and hearing/auditory training (auditory training, lip reading, and hearing-aid orientation), in a group setting for up to four BadgerCare Plus members (per Wis. Admin. Code § DHS 101.03[69]).
92511 Nasopharyngoscopy with endoscope (separate procedure)   Use this code if the speech-language pathologist actually inserts an endoscope. Do not use this code if the speech-language pathologist is providing an analysis and does not insert the scope; instead, use code 92506 or 92610, as appropriate. Use this code for evaluation of dysphagia or assessment of velopharyngeal insufficiency or incompetence. This service is to be performed according to the ASHA Code of Ethics and ASHA Training Guidelines for Laryngeal Videoendoscopy/Stroboscopy.
92512 Nasal function studies (eg, rhinomanometry)   Use this code if completing aerodynamic studies, oral pressure/nasal airflow, flow/flow studies, or pressure/pressure studies.
92520 Laryngeal function studies (ie, aerodynamic testing and acoustic testing)   Use this code for laryngeal airflow studies, subglottic air pressure studies, acoustic analysis, EGG laryngeal resistance.
92521 Evaluation of speech fluency (e.g., stuttering, cluttering)   Evaluation must provide a quantitative and/or qualitative description of the member's fluency level and/or evaluation must provide a measurement of speaking rate such as SPM. Member's fluency may be documented through results of a commercial stuttering severity instrument and/or description of frequency and severity, types of dysfluencies, secondary characteristics, and self-awareness/perception/self-correction.
92522 Evaluation of speech sound productions (e.g., articulation, phonological process, apraxia, dysarthria) Not allowed on the same DOS as 92523. Evaluation must provide a quantitative and/or qualitative description of member's speech intelligibility. Member's speech sound production may be documented using results of standardized tests, reporting percent of intelligibility by familiar and unfamiliar listeners when context is known and unknown, and/or describing signs and symptoms of disordered sound production.
92523 with evaluation of language comprehension and expression (e.g., receptive and expressive language) Not allowed on the same DOS as 92522.
If the member is evaluated only for language, procedure code 92523 should be billed with modifier 52.
Evaluation must provide a quantitative and/or qualitative description of member's speech intelligibility. Member's abilities may be documented using results of standardized tests, reporting percent of intelligibility by familiar and unfamiliar listeners when context is known and unknown, and/or reporting signs and symptoms of disordered sound production and report of member's receptive and expressive language abilities using standardized test results, norm referenced data, developmental levels, and/or estimate of language age-equivalent levels if formal testing is unable to be completed.
92524 Behavioral and qualitative analysis of voice and resonance   Evaluation must provide a quantitative and/or qualitative measurement of the member's voice and resonance including but not limited to perceptual ratings of voice quality, pitch, and loudness, and description of member's awareness of vocal problem, and phonatory behaviors.

This procedure does not include instrumental assessment.
92526 Treatment of swallowing dysfunction and/or oral function for feeding   The member must have an identified physiological swallowing and/or feeding problem. This is to be documented using professional standards of practice such as identifying oral phase, esophageal phase, or pharyngeal phase dysphagia, baseline of current swallowing and feeding skills not limited to signs of aspiration, an oral mechanism exam, report of how nutrition is met, current diet restrictions, compensation strategies used, and level of assistance needed.
92597 Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech Cannot use on the same DOS as 96105. This code describes the services to evaluate a member for the use of a voice prosthetic device (for example, electrolarynx, tracheostomy-speaking valve). Evaluation of picture communication books, manual picture boards, sign language, the Picture Exchange Communication System, picture cards, gestures, etc., are not included in the reimbursement for this code. Instead, use code 92506.
92607** Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour Cannot use on the same DOS as 96105. This code describes the services to evaluate a member to specify the speech-generating device recommended to meet the member's needs and capacity. This can also be used for re-evaluations. Evaluation of picture communication books, manual picture boards, sign language, the Picture Exchange Communication System, picture cards, gestures, etc., are not included in the reimbursement for this code. Instead, use code 92506.
92608*** each additional 30 minutes (List separately in addition to code for primary procedure) This code can be billed only in conjunction with 92607. The maximum allowable number of units for this service is one unit of 92607 and one unit of 92608 (that is, a maximum of 90 minutes).
92609 Therapeutic services for the use of speech-generating device, including programming and modification   This code describes the face-to-face services delivered to the member to adapt the device to the member and train him or her in its use.
92610 Evaluation of oral and pharyngeal swallowing function    
92611 Motion fluoroscopic evaluation of swallowing function by cine or video recording   Accompanying a member to a swallow study is not reimbursable. This code involves participation and interpretation of results from the dynamic observation of the member swallowing materials of various consistencies. It is observed fluoroscopically and typically recorded on video. The evaluation involves using the information to assess the member's swallowing function and to develop a treatment.
92612 Flexible fiberoptic endoscopic evaluation of swallowing by cine or video recording;    
92614 Flexible fiberoptic endoscopic evaluation, laryngeal sensory testing by cine or video recording; Only allowable when used in conjunction with 92612.  
92626 Evaluation of auditory rehabilitation status; first hour.    
92627 Evaluation of auditory rehabilitation status; each additional 15 minutes.    
92700 Unlisted otorhinolaryngological service or procedure   PA is always required to use this code. Use this code when no other CPT code description appropriately describes the evaluation or treatment.
96105** Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by Boston Diagnostic Aphasia Examination) with interpretation and report, per hour Cannot use on the same DOS as 92506, 92597, 92607, or 92608.  
97127** Therapeutic interventions that focus on cognitive function (e.g. attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (e.g. managing time or schedules, initiating, organizing, and sequencing tasks), direct (one-on-one) patient conduct    

* Use 92507 with modifier "UC" for therapy following a cochlear implant.

** The procedure code description defines this code as one hour. One unit of this code = 1 hour. If less than one hour is used, bill in decimals to the nearest quarter hour. For example, 45 minutes = .75 units and 30 minutes = .5 units. If more than one hour of service is provided, up to one unit of code 92608 can be used in combination with this code.

*** The procedure code description defines this code as 30 minutes. One unit of this code = 30 minutes. If less than 30 minutes is used, bill in decimals to the nearest quarter hour. For example, 15 minutes = .5 units.