New and Revised CPT Codes For 2012
Speech-Language Pathology
The following are changes and additions to CPT codes that will be effective January 1, 2012. We are including comments from the Centers for Medicare and Medicaid Services (CMS) regarding the CPT coding changes because health plans may adopt Medicare coding rules.
New & Revised Codes
Key: [Added] Deleted
- 92605 Evaluation for prescription of non-speech-generating augmentative and alternative communication device, [face-to-face with the patient; first hour] (Revised)
- 92618 Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient, each additional 30 minutes (New add-on code to 92605; list separately in addition to code for primary procedure)
- 96110 Developmental
testing; limited (eg, Developmental Screening Test II, Early Language Milestone Screen) [screening], with interpretation and report, [per standardized instrument form] (Revised)
- 96111 Developmental testing,
extended (includes assessment of motor, language, social, adaptive and/or cognitive functioning by standardized developmental instruments) with interpretation and report (Revised)
Medicare Notes
- Medicare does not separately pay for CPT codes 92605 or 92618. Medicare considers these service as always bundled into payment for other services not specified.
- Medicare no longer covers 96110 because its policy is to not cover screens. However, CMS did allow a way for Medicare to pay for developmental screening by also proposing to add a temporary code, a supplemental HCPCS Level II G-code, G0451 Developmental testing with interpretation and report, per standardized instrument, which is valued on the previously-published values of CPT code 96110. Medicare is required to pay G codes. Medicaid and private payers will often, but not always, follow suit. There is no guarantee of continued reimbursement, but G0451 may be an alternative to 96110. Because of the potential for confusion with these codes, documentation should be very clear.
New CPT Code Modifier
-33 Preventive service; for service in accordance with a US Preventive Services Task Force A or B rating, or other preventive services indentified in mandates
Note: This modifier is for Preventive Service when the primary purpose of the service is the delivery of an evidence-based service in accordance with a US Prevent Services Task Force A or B rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by appending modifier 33 to the service. For separately reported services specifically identified as preventive, the modifier should not be used.
Deleted Codes
No speech-language pathology codes have been deleted for 2012.
See also: