Top CPT Codes for Speech Therapy
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As a speech-language pathologist, it’s important to have all the tools you need in order to correctly bill insurance. The goal of this article is to demystify CPT® codes and billing for your private practice.
What is a CPT® code?
CPT® code stands for Current Procedural Terminology code, and was developed by the American Medical Association. These codes describe the services and procedures you provide as a speech-language pathologist and are included on an insurance claim you submit to your insurance payer. It’s important to note that if your practice is private pay only, you’ll still need these codes on a superbill when your clients seek reimbursement from their medical insurance carriers.
CPT® evaluation and treatment codes for speech therapy
There are two types of CPT® codes SLPs use—one for evaluation and one for treatment activities. To help give more clarity to some of the most commonly used CPT® codes for SLPs, we created the chart below so you can bill more efficiently.
What are the most common CPT® codes for speech therapy?
The most common CPT® codes for SLPs are for aphasia, cognitive based services, feeding and swallowing, speech sound production, stuttering, and voice interventions.
If you’re not sure which CPT® code to use, reach out to your insurance payer directly or visit ASHA to see a complete list of codes and updates to medical billing requirements.
CPT® codes for aphasia
CPT® code 96105
When evaluating a client with aphasia—most often as a result of a stroke—use CPT® code 96105. This code will cover all the standardized testing, client and caregiver interviews, and informal measures you use to determine the areas of language and communication most impacted by aphasia.
CPT® code 92507
If you determine that therapy is indicated, use CPT® code 92507 for all treatment sessions when you are directly addressing your client’s aphasia.
CPT® codes for cognitive-based services
The CPT codes that address cognitive communication impairments with your clients differ from others for speech-language pathology, as these codes are timed.
CPT® code 96125
Use CPT ® code 96125 for each hour spent administering, scoring, and documenting a standardized cognitive assessment.
CPT® code 97129
Code 97129 is used for the first 15 minutes of therapy targeting cognitive communication. Since this code covers the first 15 minutes, only use 97129 once per day. This treatment code can also be used in conjunction with other speech pathology codes if multiple areas of need were addressed in a treatment session. For example, if you spent time addressing swallowing or motor speech deficits, you would also code for those activities.
CPT® code 97130
If your cognitive communication therapy is longer than 15-minutes, use the add-on CPT® code 97130. Since 97130 is an add-on CPT® code, it should always be billed in conjunction with 97129. Together, both of these CPT® codes bill for the treatment of attention, memory, executive function, or compensatory strategy training.
CPT® code for feeding and swallowing
The evaluation and treatment of any disorders related to feeding and swallowing have their own set of related CPT® codes.
CPT® code 92610
The main CPT® code used for the evaluation of oral and pharyngeal swallowing function is 92610. This involves all the components of your clinical swallowing evaluation, including the client interview and patient reported outcome measures.
CPT® code 92612
Bill 92612 if your practice provides instrumental evaluations of swallowing—such as fiberoptic endoscopic evaluation (FEES). Keep in mind that laws for billing that code on its own vary from state to state.
CPT® codes 92613 and 92526
If your client brought in a FEES recording performed by another clinician or physician, the code 92613 is used for the interpretation and report of that FEES exam.
If your client’s plan of care involves the treatment of swallowing or feeding disorders, then the CPT® 92526 can be used.
CPT® codes for speech sound production and expressive and receptive language
CPT® code 92523
Evaluation code 92523 is used when both speech and language skills are evaluated with formal and informal measures. This includes standardized assessments and speech and language samples. You will designate this code when evaluating articulation, phonological processes, apraxia, or dysarthria, as well as expressive and receptive language (production and comprehension).
CPT® code 92522
The treatment code associated with evaluation code 92523 is 92507. This treatment code is comprehensive and covers most of the therapeutic activities performed by a speech-language pathologist. When used in conjunction with the above code, it serves to represent all therapeutic activities associated with speech sound production, and expressive and receptive language.
CPT® code 92507
Additionally, the evaluation code, 92522 is also associated with the treatment code 92507. This evaluation code is used when speech sound production is the only modality that is evaluated.
An important note: the two evaluation codes 92523 and 92522 may not be billed together since 92523 already includes a speech sound production evaluation. If receptive and expressive language are evaluated without speech sound production being evaluated, use CPT® code 92523.
CPT® codes for stuttering
CPT® code 92521
Evaluation code 92521 is used for stuttering and cluttering. Sessions billed with this code will include documentation of quantitative and qualitative assessments of a client’s stutter. They’ll also include a report of the client’s perception and impact of stuttering on their communication and life.
CPT® code 92507
Use treatment code 92507 in conjunction with 92521 when your treatment sessions include activities that focus on helping clients cope and manage any negative impact that stuttering or cluttering causes in their lives.
CPT® codes for voice interventions
CPT® code 92524
Code 92524 is used for the behavioral evaluation of voice and resonance. Use this code if you didn’t perform any instrumental assessment during your evaluation.
CPT® code 92520
If you performed an acoustic or aerodynamic assessment, you need to use CPT ® code 92520 to bill for those procedures.
CPT® code 31579
If you also performed additional instrumental assessments like videostroboscopy, you need to bill CPT® code 31579. Keep in mind that the use of the CPT® code 31579 without physician supervision varies from state to state.
CPT® code 92507
The treatment code for therapy targeting a voice disorder is 92507.
Where can I find more information about CPT® codes?
There are many places where you can find information about CPT® codes. Each year, the AMA makes updates or changes to CPT® codes that are ready to use on January 1st of the new year. In addition, many practice management softwares such as SimplePractice have free resources you can download to help expand your knowledge on billing and coding.
If you’re interested in finding out how you can streamline your practice and simplify insurance billing, try SimplePractice for a free, 30-day trial. It’s the only HIPAA-compliant EHR that seamlessly allows you to select and bill SLP codes, has hundreds of note templates, integrated telehealth, and more, that work specifically for speech-language pathologists.
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