CMS Proposes Medicare Payment for New Speech-Language Pathology Treatment Codes

The Centers for Medicare & Medicaid Services (CMS) has released the calendar year (CY) 2027 Medicare Physician Fee Schedule (MPFS) proposed rule, marking another major milestone in the transition to new speech-language pathology treatment codes that will replace CPT® code 92507 on January 1, 2027.

Overall, the proposed rule reflects many of ASHA's recommendations developed through years of work with practicing speech-language pathologists (SLPs), clinical experts, the American Medical Association (AMA) CPT Editorial Panel, the AMA Relative Value Scale Update Committee (RUC), and the AMA RUC Health Care Professionals Advisory Committee (HCPAC). CMS accepted the RUC HCPAC-recommended clinician work relative value units (work RVUs) and direct practice expense inputs for all 10 new speech-language pathology treatment codes without changes—an important recognition of the professional work and resources required to furnish these services.

However, the proposed rule also raises several important issues that ASHA is actively evaluating. CMS omitted RVU information for eight of the 10 new CPT codes from its published payment tables, making it impossible to determine the proposed Medicare payment rates for those services. In addition, CMS unexpectedly proposed a new HCPCS G code for pediatric speech-language pathology services that ASHA did not request and that was not part of the multi-year CPT development process.

The proposed rule is not final. ASHA is conducting a comprehensive analysis of the proposal to share with members and will submit formal comments to CMS before the September 14, 2026, deadline. CMS is expected to publish the final rule later this fall.

ASHA will also host a free member briefing on Friday, July 17 (3:00-3:30 p.m. EDT), to review the proposal and discuss what it means for SLPs. ASHA will record the webinar for those who are unable to attend live. Register here.

Key Takeaways

• CMS accepted ASHA's recommended work RVUs and direct practice expense inputs for all 10 new speech-language pathology treatment codes.
• CMS did not publish complete payment information for eight of the 10 new codes. ASHA has notified CMS of the apparent omission and has requested CMS publish a correction.
• CMS proposed a new pediatric HCPCS G code (GSLPP) that ASHA did not request and is carefully evaluating.
• CPT code 92507 remains in effect through December 31, 2026.
• The new CPT codes become effective January 1, 2027.
• Medicaid programs and commercial insurers will establish their own coverage and payment policies and are not required to adopt coding changes or Medicare payment rates.

What Is Changing?

Beginning January 1, 2027, CPT code 92507 will be deleted from the CPT code set and replaced with a new family of time-based speech-language pathology treatment codes.

The new code family more accurately reflects contemporary clinical practice by distinguishing treatment based on the primary disorder or condition being addressed.

The new structure includes:

• five clinical treatment categories;
• an initial 30-minute base code for each category;
• a 15-minute add-on code for additional treatment time for each category; and
• continued use of CPT code 92508 for group treatment.

Why These Codes Changed

For more than two decades, speech-language pathologists (SLPs) have generally reported individual treatment services using CPT code 92507.

In 2024, CMS identified 92507 for review because Medicare utilization had increased substantially over time. Under the AMA CPT and RUC processes, the code underwent a comprehensive review to determine whether it continued to accurately describe current clinical practice.

Working with practicing SLPs and clinical experts, ASHA helped develop a new code family that better distinguishes the services clinicians provide while complying with CPT coding standards.

ASHA also conducted national surveys of practicing SLPs, reviewed clinical evidence, and worked through the RUC process to develop recommendations for physician work and practice expense values. CMS relied on those recommendations in developing the proposed values in this rule. For additional background, see Update on CPT Code 92507: Valuation Review Underway.

New CPT Codes for Individual Treatment Services

The new code family separates individual treatment by the primary clinical service provided.

The table below summarizes the proposed Medicare physician work relative value units (work RVUs) and estimated national nonfacility payment amounts from the CY 2027 MPFS proposed rule, calculated using CMS's proposed conversion factor of $33.5875.

Important: These proposed national payment estimates apply only to Medicare Part B services paid under the MPFS and are not final. Payment also varies by geographic locality and other Medicare payment adjustments.

Medicaid programs and commercial health plans establish their own payment policies and are not required to adopt Medicare payment rates.

Group Treatment

CPT code 92508 will continue to be an untimed code for group treatment.

Unlike the current code set, 92508 will function as a stand-alone code rather than being linked to the individual treatment code.

Key Issues ASHA Is Evaluating

Missing Medicare Payment Information

Although CMS included work RVUs for all 10 new speech-language pathology treatment codes, only two of those codes appear in the Medicare payment tables (Addendum B). As a result, CMS did not publish practice expense RVUs, total RVUs, or proposed payment amounts for the remaining eight codes.

Proposed Pediatric HCPCS G Code

CMS also proposed a new HCPCS code—GSLPP—for pediatric speech-language pathology services.

ASHA did not request this proposal, nor was it part of the AMA CPT development or valuation process. According to CMS, the G code was developed in response to comments from interested parties who expressed concerns that the new CPT codes did not adequately represent pediatric treatment services.

CMS proposes valuing the G code by assigning it the same Medicare valuation as former CPT code 92507 (a process known as "crosswalking") while requiring 60 minutes of personally performed treatment by the billing clinician.

ASHA is carefully evaluating the proposal because it may create uncertainty regarding:

• when clinicians should report the G code versus the CPT codes;
• the proposed 60-minute billing requirement;
• administrative burden for clinicians and payers; and
• whether Medicaid programs and commercial insurers may adopt the G code.

ASHA Advocacy will address these issues in our formal comments to CMS.

Broader Medicare Payment Policies

Although CMS accepted ASHA's recommended valuation for the new code family, final payment amounts will also depend on broader Medicare payment policies that affect all services under the MPFS, including proposed changes to practice expense methodology and the Medicare conversion factor.

What SLPs Should Know Right Now

CMS has released a proposed rule—not a final policy. Although the proposal contains encouraging elements, including CMS's acceptance of the ASHA and RUC HCPAC-recommended work RVUs and direct practice expense inputs for the new CPT code family, ASHA is still conducting a comprehensive analysis of the rule, and many important questions remain unanswered.

Because of these and other issues, it is too early to draw conclusions about the overall impact of the proposed rule or individual payment rates.

The ASHA Advocacy team encourages members to avoid relying on incomplete information or speculation while the proposal is being analyzed. Our comments to CMS—and any advocacy opportunities we ask members to support—must be based on a complete understanding of the proposal and a coordinated strategy that best advances the interests of the professions.
CMS is accepting public comments through September 14, 2026. ASHA will submit comprehensive comments on behalf of audiologists and SLPs and will provide members with additional analysis, educational resources, and advocacy opportunities in the coming weeks.

In the meantime, members should:

• Register for ASHA's July 17 member briefing.
• Monitor ASHA’s website for updates.
• Read Understanding the CPT Process: How Codes Are Created and Valued.
• Subscribe to ASHA Headlines to get the ASHA Advocate for updates.

Questions?

Contact ASHA’s health care and education policy team at reimbursement@asha.org.