The following updates to Current Procedural Terminology (CPT ® American Medical Association) and Healthcare Common Procedures Coding System (HCPCS) Level II codes related to speech-language pathology services are effective January 1, 2024. Speech-language pathologists (SLPs) can contact ASHA's health care policy team at firstname.lastname@example.org for questions.
Note: SLPs should always check with payers regarding coverage of new or revised billing codes. Coding changes may not always alter payer coverage decisions for specific conditions or services.
For past updates, see speech-language pathology CPT and HCPCS code changes for 2023 and 2022.
On this page:
The following new CPT codes are effective January 1, 2024. There are no new HCPCS Level II codes related to speech-language pathology services or devices in 2024.
- These codes all represent caregiver training without the patient present, when provided under an established, individualized, and patient-centered therapy plan of care.
- These codes are not for billing for discussion/brief education with caregiver(s) immediately following a session with the patient. These activities are bundled into the payment for the direct evaluation or treatment time with patient.
- Do not bill these codes for training medical professionals or support personnel who are employed to provide health care services to the patient.
- The Centers for Medicare & Medicaid Services (CMS) will cover these services for Medicare beneficiaries when billed according to their guidelines, as outlined below. Other payers may choose to adopt these guidelines, but do not have to.
- CMS defines caregivers as "an adult family member or other individual who has a significant relationship with, and who provides a broad range of assistance to, an individual with a chronic or other health condition, disability, or functional limitation" or “a family member, friend, or neighbor who provides unpaid assistance to a person with a chronic illness or disabling condition”.
CMS indicates that caregivers must be trained by the patient’s treating clinician to assist with aspects of the patient’s care that are directly related to an established plan of care to address a diagnosed illness or injury.
CMS also notes the patient should agree to caregiver involvement and will require clinicians to document the patient’s or their representative’s specific consent for the caregiver(s) to receive training without the patient present.
- For Medicare, report these codes with the "GN" modifier to indicate that services were provided under a speech-language pathology plan of care.
- 97550 and 97551: These are timed codes to describe the first 30 minutes (97750) and each subsequent 15 minutes (97551) of time for caregiver training, without the patient present. For more on billing timed codes, see The Right Time for Billing Codes.
- Report 97550/97551 when providing training to the caregiver(s) of a single patient. Billing is based on the patient, not the number of caregivers present.
- Example: You see the parents of a child for training to support the child’s use of augmentative and alternative communication (AAC) to communicate with family members and friends. This session was specifically included in the POC for time without the child present. The session lasts a total of 45 minutes. In this scenario, you are seeing the caregivers of one child, so you will report one unit of 97550 for the first 30 minutes and one unit of 97551 for the additional 15 minutes of time. You would not bill each code twice to represent each parent.
- 97552: This is an untimed code for reporting group training for the caregivers of multiple patients. Group training may be indicated when the patients have similar conditions and/or similar therapy goals or needs.
- Bill 97552 once per patient represented, regardless of the number of caregivers in the session.
- Example: You have been treating three patients with dysphagia and determine that the caregivers of each of these patients could benefit from group training to learn how to modify and set up meals and use cueing to support safe swallowing in the home environment. A total of five caregivers representing three patients (in other words, three sets of caregivers) participate in a 60-minute training session without the patients present. In this scenario, you will report 97552 once for each patient represented. This means you will report 97552 a total of three times for that session. You would not bill 97552 five times for each of the five caregivers present.