2025 CPT code 92507
(Active) Effective Date: N/A Revision Date: N/A Evaluation and Treatment of Communication Disorders - Speech-Language Pathology Medicine Services and Procedures > Special Otorhinolaryngologic Services and Procedures Feed
Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual.
Modifiers may be applicable depending on the specific circumstances of service. Consult your local Medicare carrier guidelines and payer-specific instructions.
Medical necessity is established through a comprehensive evaluation revealing a communication or auditory processing disorder that significantly impairs the patient's ability to function in daily life.The treatment must be reasonable and necessary to improve the patient's communication and/or auditory processing skills. Documentation should clearly demonstrate the need for speech-language pathology services.
The clinical responsibility involves comprehensive evaluation of the patient's communication and auditory processing skills. The provider designs and implements a treatment plan tailored to the patient's needs, monitors progress, and adjusts the plan as needed.Documentation of the assessment, treatment, and progress is crucial.
- Medicine Services and Procedures > Special Otorhinolaryngologic Services and Procedures
- Special Otorhinolaryngologic Services and Procedures
In simple words: This code covers a doctor's assessment and treatment plan for someone having trouble with speech, language, voice, or hearing. The doctor will check how well the person can make sounds, understand words, and express themselves.Treatment might include teaching sounds and words, doing exercises for mouth muscles, and practicing communication skills.
This CPT code encompasses the evaluation and treatment of various communication and auditory processing disorders in an individual patient.The evaluation may include assessment of speech sound production, articulatory movements, oral-pharyngeal swallowing function, voice and resonance quality, and stuttering characteristics. It also assesses receptive and expressive language abilities, including comprehension and formulation of verbal and written expressions. Treatment may involve articulation therapy, oral motor exercises, receptive and expressive language therapy, and strategies to improve communication using alternative methods such as actions and lip movements.The provider documents the patient's responses and guides them in their daily activities.
Example 1: A 5-year-old child presents with significant speech sound production difficulties, resulting in limited communication abilities. The speech-language pathologist (SLP) uses 92507 to code for the initial comprehensive evaluation and subsequent articulation therapy sessions.The SLP performs several assessments, designs a treatment plan targeting specific sounds, and provides regular progress reports to the parents and the referring physician., A 70-year-old stroke patient exhibits expressive aphasia. The SLP uses code 92507 to bill for the assessment and subsequent sessions focusing on expressive language therapy. The SLP employs various techniques such as picture cards, verbal cues, and writing prompts to aid the patient's communication. The SLP closely monitors the patient's progress and adjusts the treatment approach based on their response., An adult patient is diagnosed with an auditory processing disorder (APD). The SLP uses code 92507 to represent the detailed evaluation of their auditory processing skills and subsequent treatment focusing on auditory training exercises and compensatory strategies to improve their listening and comprehension abilities in various environments. The SLP involves the patient's family and teachers in the process to help them support the patient's progress.
Comprehensive documentation is essential and should include the initial assessment findings, the diagnosis, the treatment plan, the progress notes, and any modifications made to the treatment plan during the course of therapy. Detailed notes are critical for justifying medical necessity and supporting proper billing.
** This code is used for individual treatment sessions. For group treatment, use code 92508.Always refer to the most current CPT coding manual and payer guidelines for the most accurate and up-to-date information.
- Revenue Code: M5D (SPECIALIST - OTHER)
- RVU: The RVUs for this code will vary depending on the payer and geographic location. Consult the specific payer's fee schedule for the most up-to-date information.
- Global Days: Not applicable; this is not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable; this code does not have a technical component.
- Fee Schedule: Historical fee schedule data is not provided in the source.Consult the AMA's CPT codebook and payer-specific fee schedules for historical data.
- Specialties:Speech-Language Pathology, Audiology, Otolaryngology
- Place of Service:Office, Hospital Outpatient, School, Home Health