CPT Code 92608: A Guide to Billing for AAC Evaluations

Augmentative and alternative communication (AAC) provides a way for patients with severe speech or language impairments to communicate. As an SLP, prescribing AAC devices is an important service you can provide. Properly billing for AAC evaluations with CPT code 92608 is key to getting reimbursed. This guide will cover everything you need to know about using 92608 for AAC assessments.

What is CPT Code 92608?

92608 cpt code stands for “Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first 30 minutes.”

It involves the clinical assessment to determine if an AAC device is appropriate for a patient and which type of device should be recommended.

92608 specifically covers:

• Interviewing the patient/family
• Reviewing medical records
• Conducting communications testing
• Digital trials of communication software
• Determining access methods
• Writing a letter of medical necessity

This code covers the first 30 minutes of an AAC evaluation. Each additional 30 minutes is billed separately using code 92609.

Billing Guidelines for 92608

When using CPT code 92608, proper billing practices are important:

• Bill 92608 only for direct face-to-face time with the patient. Non-face-to-face time falls under code 92607.
• For evaluations over 30 minutes, use 92609 for each additional 30 minutes.
• Link the assessment to a relevant diagnosis like cerebral palsy, ALS, stroke, etc.
• Provide detailed notes outlining the medical necessity for the AAC device.
• Bill 92608 only once per patient per assessment. Don’t use it for follow-ups.
• 92608 can only be billed by the SLP conducting the evaluation.

92608 Coverage and Reimbursement

Many private insurers and government payers like Medicare cover CPT code 92608. Exact reimbursement depends on factors like:

• Payer (Medicare vs private insurance)
• Place of service (inpatient vs outpatient)
• Geographic location

According to the 2023 Medicare Physician Fee Schedule, the national average payment for 92608 is $61.92.

Always verify coverage and reimbursement rates with local payers before billing 92608. A letter of medical necessity and preauthorization may be required.

Examples of Proper 92608 Billing

Here are some examples of appropriate use of CPT code 92608:

Patient is a 32-year-old male with ALS reporting significant communication deficits. I completed a 30 minute face-to-face AAC evaluation, reviewed medical records, performed communication testing, trialed an eye gaze device, and provided a written report on findings and device recommendations. Billed 92608.

45 minute face-to-face AAC evaluation was completed for 63-year-old female patient status post stroke with severe dysarthria and apraxia of speech. Patient demonstrated functional communication using speech-generating device. Billed 92608 for first 30 minutes and 92609 x1 for additional 15 minutes of assessment.

92608 vs 92607

It’s important to distinguish between 92608 and 92607:

• 92608 is for direct face-to-face time conducting the AAC evaluation.
• 92607 is for non-face-to-face time spent reviewing records, scoring protocols, writing reports etc.

Do not bill these codes together on the same date of service. 92607 may be billed on separate dates from the evaluation.

Changes to 92608

The CPT Editorial Panel reviews codes annually and implements changes as needed. Updates to 92608 in recent years include:

2021: Description revised to clarify face-to-face time

2020: Guidelines added to clarify first 30 mins vs additional time

Stay current on code changes that impact your practice, as they may affect payment.

The Role of 92608 in SLP Practice

For SLPs performing AAC evaluations, correctly using CPT code 92608 is very important for the following reasons:

• Ensures accurate billing for your professional services
• Provides justification for medical necessity of AAC
• Allows tracking of patient load and practice metrics
• Promotes compliance with payer billing regulations
• Enables comparison of reimbursement rates across payers
• Contributes data to support coverage of SLP services

Conclusion

Evaluating patients for augmentative and alternative communication devices is an essential part of SLP dysarthria and apraxia management. CPT code 92608, along with 92607 and 92609, allow you to be reimbursed for this specialized assessment and treatment planning. Following payer guidelines and documenting the medical necessity for AAC will ensure maximum reimbursement.

FAQs

Can 92608 be billed for a follow-up assessment?

No, 92608 is for the initial evaluation only. Any follow-up would fall under code 92607.

What if most of my time was spent on the trial use and not the evaluation?

The code billed should reflect the primary purpose of the service. In this case, 92608 for the prescription of the device.

Can I bill both 92608 and 92507 on the same day?

No, only one evaluation code can be billed per patient per day of service.

What if I spent 60 minutes on the evaluation?

Bill 92608 for the first 30 mins, and 92609 x2 for the additional 30 mins.