2025 CPT code 96105
(Active) Effective Date: N/A Medicine - Central Nervous System Assessments/Tests Feed
Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing)
Modifiers may be applicable to 96105 to indicate specific circumstances, such as reduced services (modifier 52) or discontinued procedures (modifier 53). Modifier 59 is for distinct procedural services. Modifiers 76 and 77 are for repeat services.
Medical necessity for 96105 is established when a patient exhibits signs or symptoms of aphasia, such as difficulty speaking, understanding language, reading, or writing.The assessment is necessary to determine the presence, type, and severity of aphasia, and to guide appropriate interventions and treatment planning.
The physician or other qualified healthcare professional performs the assessment of aphasia, interprets the findings, and creates a report.This involves analyzing the patient's ability to understand and produce language, both spoken and written.They use standardized tests and clinical observations to determine the severity and type of aphasia.
In simple words: This code covers a one-hour evaluation by a healthcare professional, often a speech-language pathologist, to assess language difficulties (aphasia) caused by conditions like stroke or brain injury. The evaluation checks how well a person understands and uses words, speaks, reads, writes, and spells.
Assessment of aphasia involves evaluating expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, and writing.It often utilizes standardized tests like the Boston Diagnostic Aphasia Examination. The service includes interpretation and report and is billed per hour.
Example 1: A patient post-stroke exhibits difficulty speaking and understanding language. A speech-language pathologist performs a comprehensive aphasia assessment using standardized tests and clinical observation to determine the type and severity of aphasia, and to develop a treatment plan., A patient with a traumatic brain injury experiences persistent problems with reading and writing.The physician conducts an aphasia assessment to identify specific language deficits and recommend appropriate therapies., A patient with dementia shows progressive decline in communication skills. An assessment of aphasia is performed to differentiate language deficits due to aphasia from those caused by dementia, and to tailor communication strategies.
Documentation should include the type of assessment used (e.g., Boston Diagnostic Aphasia Examination), specific test results, a detailed description of the patient's language abilities and deficits (expressive and receptive language, reading, writing, spelling), the total time spent in face-to-face interaction with the patient for the assessment, and a report summarizing the findings and recommendations.
- Specialties:Speech-Language Pathology, Neurology, Physiatry (Physical Medicine and Rehabilitation)
- Place of Service:Inpatient Hospital, Outpatient Hospital, Skilled Nursing Facility, Rehabilitation Facility, Office, Home,and other places as determined by medical necessity