CPT Code 92523: Speech-Language Pathologists

As a speech-language pathologist (SLP), having a solid grasp of the CPT (Current Procedural Terminology) coding system is imperative for accurate billing and reimbursement. One important code that SLPs need to understand is CPT code 92523, used for the evaluation of speech sound production and language comprehension and expression. This code plays a key role in billing for comprehensive speech and language evaluations for new clients.

What is CPT Code 92523?

CPT code 92523 is defined by the American Medical Association (AMA) as the evaluation of speech sound production with evaluation of language comprehension and expression. This code is used when a thorough evaluation of both speech sound production abilities and receptive/expressive language skills is completed.

CPT codes like 92523 are part of a uniform coding system implemented for consistency in medical billing and documentation. They are attached to documentation to bill services to insurance companies and government payers like Medicare and Medicaid. Using the proper CPT code ensures services are reimbursed accurately.

When Should SLPs Use 92523?

SLPs should use CPT code 92523 when conducting a comprehensive communication evaluation, assessing both speech sound production and language comprehension/expression. It can be used across settings like hospitals, schools, and private practices.

Some examples of assessments where code 92523 would apply:

• Evaluating speech sound disorders like articulation errors, phonological processes, Apraxia of Speech, dysarthria, and more in pediatric or adult populations
• Evaluating receptive and expressive language skills in clients with delays, disorders, or suspected disability
• Screening speech and language as part of a full case history evaluation

Things to Know About CPT Code 92523

• The code is not time-based – it can be billed once per day regardless of the length of the evaluation
• 92523 cannot be used for treatment sessions, only evaluations
• Stuttering/fluency evaluations have their own codes – 92523 is reserved for speech sound and language assessments
• Only one unit of 92523 can be billed per client per day to avoid errors
• Reimbursement rates differ based on location and payer (e.g. Medicare vs. a private insurer)
• SLPs should refer to the CPT codebook each year, as codes are updated annually on January 1st
• In 2014, 92523 replaced the less specific 92506 evaluation code

Avoiding Errors with CPT Code 92523

To avoid claim denials and reimbursement issues, SLPs should take care to:

• Use 92523 only for speech and language evaluations, not treatment
• Refrain from billing 92523 more than once per client per day
• Check payer policies – some restrict 92523 to certain age groups
• Select codes that most accurately represent the services provided
• Review CPT code definitions in the AMA CPT Manual
• Verify diagnosis codes used support medical necessity

With proper understanding of CPT coding, SLPs can ensure they receive payment for important evaluation services. Staying up-to-date on codes like 92523 is a key part of ethical, accurate billing and reimbursement.