2025 CPT code 92523
(Active) Effective Date: N/A Medicine - Special Otorhinolaryngologic Services and Procedures Feed
Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language).
Modifiers are allowed. Modifier -52 can be used if only a portion of the service is performed (e.g. if only language is evaluated).Modifier -59 should be appended when distinct evaluations for different speech/language components are performed on the same day and documented in separate reports.
Medical necessity must be established for this evaluation.Documentation should support the reason for the evaluation, relating the patient's difficulties to functional limitations in communication. The medical record should indicate the specific concerns that prompted the evaluation and how the findings will be used to develop a treatment plan.
The speech-language pathologist is responsible for conducting the evaluation, which includes administering standardized tests, observing the patient's communication, and analyzing the results to determine the patient's strengths and weaknesses in speech sound production, language comprehension, and expression.Based on the evaluation, the SLP may recommend further assessment or treatment.
In simple words: A speech-language pathologist assesses how a person makes speech sounds, how they understand language, and how they use language to communicate.
This code encompasses the evaluation of speech sound production, including articulation, phonological processes, apraxia, and dysarthria, along with the evaluation of language comprehension and expression, both receptive and expressive language skills.It involves assessing a patient's ability to produce speech sounds correctly, understand spoken and written language, and express thoughts and ideas effectively.
Example 1: A 3-year-old child exhibits difficulty pronouncing words and has a limited vocabulary. The SLP uses 92523 to bill for the evaluation of both the child's speech sound production and their receptive and expressive language skills to determine if apraxia or other speech sound disorders are present., A 6-year-old child has difficulty understanding instructions and expressing their needs. The SLP bills 92523 to evaluate their language comprehension and expression, and also checks their speech sound production informally to determine eligibility for services., An adult patient following a stroke has trouble speaking and understanding language. While 96105 might be considered for aphasia assessment, if the SLP performs a comprehensive evaluation of both speech sound production and language comprehension/expression, 92523 can be used.
Documentation should include a detailed description of the evaluation procedures, including the tests administered, patient responses, and the SLP's clinical impressions. The report should clearly document the patient's abilities in speech sound production, receptive language, and expressive language, including specific examples and quantifiable data wherever possible. Any standardized tests used should be named, and scores should be documented.
- Revenue Code: T2D (OTHER TESTS - OTHER)
- Specialties:Speech-Language Pathology
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital, Skilled Nursing Facility, Home Health, Schools, and other settings where speech-language pathology services are provided. Telehealth modifiers (such as 95 or GQ) may also be applicable when services are rendered via telecommunication systems.