Summary & Overview
CPT 92507: Individual Treatment of Speech, Language, Voice, and Communication Disorders
CPT code 92507 represents individual treatment for speech, language, voice, communication, and auditory processing disorders. This code is widely used by speech-language pathologists to deliver targeted therapy aimed at improving communication abilities in patients with a variety of disorders, including phonological, expressive language, and aphasia. The service is most commonly provided in an office setting, reflecting its role in outpatient care.
Major national payers covering this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies and reimbursement benchmarks for 92507 are essential for providers and stakeholders to understand, as they impact access to speech-language pathology services across the country.
This publication offers a comprehensive overview of 92507, including payer coverage, clinical context, and related billing codes. Readers will gain insight into current policy updates, typical diagnoses associated with the code, and how it fits within the broader landscape of speech-language pathology services. The analysis also highlights relevant modifiers and taxonomies, providing a clear picture of how this code is utilized in clinical practice.
CPT Code Overview
CPT code 92507 is used to report the treatment of speech, language, voice, communication, and/or auditory processing disorders provided to an individual. This service falls under the Speech-Language Pathology category and is typically performed in an office setting (Place of Service 11). The procedure is designed to address a range of communication challenges, supporting patients in improving their speech and language abilities through individualized therapy sessions.
Clinical & Coding Specifications
Clinical Context
A patient, such as a child or adult, presents to a speech-language pathologist in an office setting (Place of Service 11) with difficulties in speech, language, voice, communication, or auditory processing. The patient may have a diagnosis such as phonological disorder, expressive language disorder, mixed receptive-expressive language disorder, aphasia, or apraxia. After an initial evaluation, the provider develops an individualized treatment plan. The patient attends regular, one-on-one therapy sessions focused on improving specific communication abilities, which are documented and billed using CPT code 92507.
Coding Specifications
| Modifier Code | Description |
|---|---|
GN | Services delivered under an outpatient speech-language pathology plan of care |
GO | Services delivered under an outpatient occupational therapy plan of care |
- Modifier
GNis used when the service is part of a speech-language pathology plan of care, typically required by payors such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare for outpatient therapy claims.