Speech-Language Pathology CPT and HCPCS Code Changes for 2025

The following updates to Healthcare Common Procedures Coding System (HCPCS) Level II codes related to speech-language pathology services are effective January 1, 2025. Note that there are no changes to Current Procedural Terminology (CPT ® American Medical Association) codes related to speech-language pathology services in 2025. Speech-language pathologists (SLPs) can contact ASHA's health care policy team at reimbursement@asha.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 2024 and 2023.

On this page:

Caregiver Training for Functional Performance
Caregiver Training for Primary Care Services
Resources

Caregiver Training for Functional Performance

Beginning in 2024, SLPs have been able to report caregiver training without the patient present for related to the patient's functional performance using CPT codes 97550-97552 when provided under an established, individualized, and patient-centered plan of care to facilitate a patient’s functional performance.

Although there are no changes to the codes for 2025, the Centers for Medicare & Medicaid services expanded its policy regarding patient consent to allow clinicians to obtain verbal consent from the patient or the patient representative to provide caregiver training without the patient present. The consent, whether written or verbal, must be documented in the medical record.

For more information on this policy update, see ASHA's summary of the 2025 Medicare Fee Schedule final rule.

Caregiver Training for Primary Care Services

The following new codes are effective beginning January 1, 2025. These G-codes are Medicare-specific. Other payers may add them to their fee schedules but it is important to check with them directly before billing these codes. For more information on the new codes, see ASHA's summary of the 2025 Medicare Fee Schedule final rule.

G0541

Caregiver training in direct care strategies and techniques to support care for patients with ongoing conditions or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present), face-to-face; initial 30 minutes

G0542

(Use G0542 in conjunction with G0541)

G0543

Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present), face-to-face with multiple sets of caregivers

ASHA Notes

SLPs should keep in mind that services reported using these G-codes are distinctly different from CPT codes 97550-97552, which focus on caregiver training to support a patient’s functional performance.
These G-codes should only be reported for those times when an SLP may be providing training without the patient present to provide caregiver(s) with strategies to help reduce complications.
This training should not be associated with goals related to a patient’s functional performance. In addition, the services described by the new G-codes must be incorporated into the patient’s plan of care.
- If a patient is already under a therapy plan of care, this may be as simple as updating and recertifying the plan of care. However, Medicare hasn’t provided guidance in those instances when a patient isn’t currently under a therapy plan of care, but has been referred to the SLP for services.
- We will provide updates on this page as more guidance becomes available.
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 or patient representative should agree to caregiver involvement and will require clinicians to document the patient’s or their representative’s specific verbal or written 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.

How To Bill

G0541 and G0542: These are timed codes to describe the first 30 minutes (G0541) and each subsequent 15 minutes (G0542) of time for caregiver training, without the patient present. For more on billing timed codes, see The Right Time for Billing Codes.
- Report G0541/G0542 when providing training to the caregiver(s) of a single patient. Billing is based on the patient, not the number of caregivers present.
G0543: 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 goals or needs.
- Bill G0543 once per patient represented, regardless of the number of caregivers in the session.

Examples

Here are examples of situations when SLPs provide medically necessary caregiver training services that could fall under these new caregiver training codes.

Example 1: Wound, stomal, and tracheoesophageal puncture (TEP) care in laryngectomy patients: Improper stomal and TEP care can lead to significant negative health outcomes. In these situations, caregivers play a vital role in ensuring proper stomal and TEP care by providing cleaning, humidifying, and monitoring of the sites for granulation tissue, fistula, and leakage in order to prevent complications. Caregivers of these patients may require extensive training on infection control and prevention, stomal and wound care, functioning of a TEP prosthesis, how to detect signs of a malfunctioning prosthesis, and the need for a new prosthesis. This training, which is not directly related to the patient’s functional performance, could be completed by SLPs and billed under these Medicare-specific -G-codes.
Example 2: Pain and lymphedema management in head and neck cancer patients: Lymphedema and pain are devastating conditions that frequently follow surgery and/or radiation treatment for head and neck cancer. Head and neck lymphedema lead to other complications such as infections or trismus. These patients often rely on their caregivers to monitor lymphedema and prevent complications, such as the need for tracheostomy. Caregiver training that SLPs may provide includes supporting lifestyle modifications, detecting worsening lymphedema, and preventing infection, which could be billed under these new codes.