American Speech-Language-Hearing Association

New Evaluation Codes for SLPs Available January 1, 2014

(September 23, 2013)

At the request of the American Medical Association's (AMA) Relative Value Update Committee (RUC), four new Current Procedural Terminology (CPT© American Medical Association) codes were created to replace CPT Code 92506 (Evaluation of speech, language, voice, communication, and/or auditory processing), effective January 1, 2014. With this change, speech-language pathologists (SLPS) will be able to bill speech, language, fluency, and voice evaluations using the following, more specific, codes:

  • 92521 Evaluation of speech fluency (e.g., stuttering, cluttering)
  • 92522 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria)
  • 92523 Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language)
  • 92524 Behavioral and qualitative analysis of voice and resonance

Information regarding Medicare payment of these codes will be published in the 2014 Medicare Fee Schedule, which is slated to be released in early November of this year.

Background

On July 16, 2008, the 110th Congress passed H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), that included a provision for SLPs in private practice to obtain a Medicare provider number so that SLPs could directly bill Medicare for services, effective July 1, 2009. Prior to this change in SLP provider status, the assigned relative value used in calculating Medicare outpatient reimbursement rates for speech-language pathology procedure codes was determined by practice expense and professional liability, but did not include a value for professional work of the SLP (the amount of time, technical skill, physical effort, stress, and judgment required to provide the service).

Since 2009, ASHA has been working with the AMA RUC to revalue speech-language pathology related codes to reflect the professional work component. During this process, the RUC saw a need for more specific codes to replace CPT Code 92506; the single code made it difficult to assign professional work values that reflect the diverse types of work that go into evaluations for speech, language, fluency, and voice disorders. Unlike practice expense, professional work values do not change over time, allowing reimbursement rates for speech-language pathology codes to remain relatively stable.

Resources

ASHA will provide speech-language pathologists with additional information on the use of these new codes through The ASHA Leader, ASHA Headlines, and ASHA's billing & reimbursement website.

For questions, please contact ASHA's health care economics and advocacy team at reimbursement@asha.org.


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