Speech-Language Pathology CPT Codes: January 1, 2014 Update

Effective January 1, 2014, the commonly used CPT code 92506 for evaluation of speech, language, voice, communication, and/or auditory processing will be deleted and replaced with four new, more specific evaluation codes. This code is frequently utilized by Speech-Language Pathologists in the Skilled Nursing Facility setting.

The new codes are:

• 92523 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)
• 92522 Evaluation of speech sound production (e.g., articulation, phonological process, Apraxia, dysarthria)
• 92524 Behavioral and qualitative analysis of voice and resonance
• 92521 Evaluation of speech fluency (e.g., stuttering, cluttering)

For speech-language evaluations within the SNF setting, 92523 Evaluation of speech sound production with evaluation of language comprehension and expression, will likely be the most commonly utilized replacement code. Speech-Language Pathologists should carefully read each CPT description to ensure they accurately bill for the service they provide.

Kris B Harmony reminds facilities that for Medicare Part B G-Code reporting is required with all evaluation codes. For example, if a voice evaluation (92524) is completed and billed after an evaluation of sound production and language (92523), reporting will be required when the second evaluation is complete. 

CMS clarified the method of this reporting and stated that the second evaluation would require a therapist to report as if this was a one-time visit and would require reporting of all three G-Codes in the code set for the functional limitation that most closely matches that for which the evaluative procedure was furnished.  This would allow for the primary functional limitation to continue without disruption. 

Since these services are considered more specific subsets of the original 92506 code, there is the potential that that reimbursement under Medicare Part B may reflect a reduction.

Skilled Nursing Facility Rehabilitation Managers need to prepare by ensuring that all of their therapy documentation, billing logs and electronic medical record systems are prepared for the change on or before January 1^st. The new codes should be added and 92506 should be deleted from all billing logs and documents for use on January 1, 2014.